A comparison between clinical decisions made about lung cancer patients and those inherent in the corresponding Scottish Intercollegiate Guidelines Network (SIGN) guideline

نویسندگان

  • Derek H. Sleeman
  • Laura Moss
  • Elias Gyftodimos
  • Marianne Nicolson
  • Graham Devereux
چکیده

Treatment and survival for patients with lung cancer vary between and within countries. We have undertaken a multifaceted study of a clinical dataset of 635 patients, to see if clinician treatment decisions were being made consistently and in accordance with the appropriate Scottish Intercollegiate Guidelines Network (SIGN) document. Subsequently, we created a dataset of 117 patients who should have undergone surgery according to the SIGN guideline. As analyses of this dataset did not provide clear distinctions between the main treatment groups, a clinician reviewed the case notes and dataset, checking for inconsistencies. The revised dataset was processed by a decision tree algorithm which suggests clinically plausible decisions. Further, statistical analyses compared the 54 patients offered surgery with the 52 who were not. These analyses suggest that there are significant differences: the most discriminating feature is significant co-morbidity (p < 0.001). The article concludes with suggestions for how future guidelines might be enhanced.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Glaucoma-service provision in Scotland: introduction and need for Scottish Intercollegiate Guidelines Network guidelines

PURPOSE To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care. MATERIALS AND METHODS A glaucoma...

متن کامل

Scottish Intercollegiate Guidelines Network: the first 15 years (1993-2008).

The Scottish Intercollegiate Guidelines Network (SIGN) was established in 1993. One of the first national programmes of evidence-based clinical practice guidelines, it has played a lead role internationally in many of the developments in guideline methodology. The challenges faced from the beginning of the organisation up to its integration into the National Health Service and how they were add...

متن کامل

Differential research impact in cancer practice guidelines’ evidence base: lessons from ESMO, NICE and SIGN

Background This is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN). Methods A total of 101 CPGs were identified fr...

متن کامل

A Systematic Review of Clinical Practice Guidelines for Castration-Resistant Prostate Cancer

Cancer constitutes a huge burden on societies in countries with any level of economic development. Prostate cancer is the first most diagnosed cancer of men in developed countries and the forth one in developing countries in terms of incidence rate. It is also the third incident cancer of men in Iran along with a prevalence of about 10,000 cases. Castration-resistant prostate cancer (CRPC) is a...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Health informatics journal

دوره 16 4  شماره 

صفحات  -

تاریخ انتشار 2010