"Management of Lung Cancer: A Comparison of Management Strategies, Outcomes and Resource Utilisation in Specialist and Non-Specialist Centres"

Project Summary and Objectives:

In the absence of agreed guidelines the management of lung cancer varies from institution to institution. Controlled studies have demonstrated no significant survival advantage between established therapies in common use. There is a lack of data to indicate how these are applied in non-specialist settings and no information about quality of life outcomes or resource consequences, which are crucial to evaluating the cost benefit ratio of management policies.

This study aims to expand on an earlier audit to compare prospectively, the management processes and outcome (in terms of symptom control, quality of life, survival and resource utilisation) for an unselected series of new patients referred to chest physicians, diagnosed as having lung cancer and managed in three different clinical care settings, i.e. district general hospital, teaching hospital and regional cancer centre. The ultimate aim of the study is to provide systematic data to inform future treatment and supportive care strategies to ensure optimal patient outcomes and resource use.

Study Objectives

1. To assess and compare the characteristics of patients selected for curative/palliative/supportive therapy by respiratory physicians in DGH versus academic centres.
2. To assess and compare the primary treatment decision for each category of patient (i.e. curative/palliative/supportive care) in the DGH versus academic centre.
3. To assess and compare characteristics of patients whose lung cancer is primarily managed by clinicians in the DGH versus academic centre versus oncology centre.
4. To assess and compare the outcome of treatment 1 month, 3 months and 6 months post diagnosis of lung cancer patients whose care is organised by each centre.
5. To compare the survival time for lung cancer patients primarily managed by each of the 3 centres.
6. To identify and cost resources used by each patient in order to compare the resource use consequences of management practices for each category of patient in each of the 3 settings.

Conference presentations

Poster presentation. The 1st European Conference on the Economics of Cancer. Palais de Congres, Brussels, Belgium. November 19-21, 1997.

Further information may be obtained from:

Dr Ann Cull
Consultant Clinical Psychologist
c/o Department of Clinical Psychology
Outpatient Building
Western General Hospital
Crewe Road
Edinburgh   EH4 2XU

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