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I.N. Olver
Moderator of
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O11 - Symptom Management (ID 137)
- Event: WCLC 2013
- Type: Oral Abstract Session
- Track: Supportive Care
- Presentations: 10
- Moderators:B. Ivimey, I.N. Olver
- Coordinates: 10/28/2013, 16:15 - 17:45, Bayside Gallery A, Level 1
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O11.01 - Wiki-based treatment guidelines for lung cancer (ID 1274)
16:15 - 16:25 | Author(s): I.N. Olver, J. Von Dincklage, L. Holliday, C. Vuletich
- Abstract
- Presentation
Background
The updating of written clincial practice guidelines regularly is difficult and expensive. New evidence in cancer treatment is published frequently. Guideline booklets are difficult to disseminate widely and stakeholder feedback is mainly pre-publication. To enable lung cancer guidelines to be rapidly updated and widely disseminated and therefore more likely to be utilised, Cancer Council Australia developed a web-based wiki platform for guidelines and is evaluating its impact.Methods
The initial methodology paralled the steps in published written guideline development but these were integrated with the wiki capability. An expert group, whose competing interests were documented, were identified, the key clinical questions and search strategies were developed for each question and literature searches recorded on the wiki. An online literature screening and critical appraisal process was developed. This provides data on which papers were used to form the guidelines and why papers were either selected or rejected depending on their quality. Evidence-based recommendations were formulated and evidence tables automatically generated. The wiki was closed in that only the invited experts could write or change a guideline but any stakeholder could comment on the guidelines at any time and the writing group would review and respond to comments. The initial vesion of the guidelines were distributed for targetted review by expert groups. We used web analytics to monitor usage. The writers remain engaged to appraise new papers and update the guideline rapidly as necessary. All previous versions could be accessed.Results
Evaluation of the lung caner treatment guidelines developed on the wiki, showed that 22 authors had identified 67 clinical questions covering treatment of all stages of lung cancer. The literature search and screening process resulted in 2035 potentially relevant articles being forwarded for detailed methodological evaluation with another 571 added through snowballing and other methods. To fine-tune the initial draft content, the working party used the wiki to exchange 156 internal comments in 9 weeks. When the guidelines were released for the initial 30-day public consultation period, 1055 users visited lung cancer content pages. The majority of users (487) accessed the guidelines directly as a result of targeted emails, while 387 found the site by Google searches. Most respondents were from Australia (799) and New Zealand (60) with the United States (47) having the largest user group of respondents from the other countries who visited the site. A survey of the usability of the site indicated widespread acceptance. The average time on a content page was 1:27minutes. The landing page was the most popular content page with 3426 page views and an exit rate of 18.85%, which indicates that the landing page served as an important tool for visitors to navigate the guidelines. To date there were 38 external comments which occasioned 31 edits by the working party.Conclusion
Adopting a platform built on MediaWiki, and moving to electronic guidelines has allowed rapid updates as new evidence becomes available and wider dissemination than print formats. The next strategy to boost uptake is to write Qstream education modules to accompany the guidelines.Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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O11.02 - The "CLiC" Cough in Lung Cancer Study: The Characterisation of Cough in Lung Cancer (ID 2986)
16:25 - 16:30 | Author(s): A.S.M. Harle, A. Molassiotis, J. Smith, F. Blackhall
- Abstract
- Presentation
Background
The “CLiC” Study seeks to characterise cough and identify its predictors using subjective and objective cough assessment tools, including the recently validated Manchester Cough in Lung Cancer Scale (MCLCS). Results will enable the identification of robust endpoints and therapeutic targets for novel antitussive interventional trials.Methods
Patients with lung cancer (LC) and complaining of cough were recruited irrespective of stage and treatment, from two cancer centres. Demographic and clinical data were collected. Patients completed the MCLCS, Cough Severity Diary (CSD), cough severity Visual Analogue Scale (VAS) and the Brief Reflux Inventory (BRI, a validated 5-item questionnaire assessing gastro-oesophageal reflux disease (GORD)). The oncology specific European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire (EORTC QLQ) C30 with the module (LC13), (including item 31: "In the past week, how often did you cough?") was also completed. Cough was graded according to Common Toxicity Criteria for Adverse Events (CTCAEv4.0). A sample size of 178 patients was required for analysis of 160 (based on Peduzzi J Clin Epidem 1996) for 10 participants per correlate per outcome in binary logistic regression, assuming a 10% attrition rate, the prevalence of severe cough to be 50% and 8 cough predictors.Results
We recruited 179 patients (Oct'11-Nov'12). The median age was 65 yrs (range 25-83 years), with 53% patients male. The majority (79%) had non small cell lung cancer (NSCLC) and advanced stage disease (>IIIA 60%). In total, 36% were receiving cancer therapy at entry. Overall, 60% felt their cough warranted treatment. Having ensured validity of the cough assessment tools, the mean cough severity score (VAS) (n=171) was 43.4mm (SD 29.6). The mean cough-specific QoL score (MCLCS) was 25.3 (SD 8.8, with a range 1-50, high scores representing worse QoL).Table showing association between cough predictors and cough severity (VAS) and cough specific QoL (MCLCS) scores on univariate analysis[*] Cough Severity (VAS) Cough Specific QoL (MCLCS) Comment Age (≤70yrs vs >70yrs) p=0.365# p=0.834# Gender p=0.048# p=0.171# women worse cough severity Smoking Status (current, ex, never) p=0.191## p=0.356## Performance Status (WHO PS 0-3) p<0.0001## p<0.0001## poorer PS worse cough severity poorer PS worse cough related QoL Histology (NSCLC vs SCLC) p=0.348# p=0.274# Stage (early vs advanced) p=0.358# p=0.301# Tumour Location (central vs peripheral) p=0.486# p=0.040# central tumours poorer cough related QoL COPD (Chronic Obstructive Pulmonary Disease) (self-reported) p=0.578# p=0.128# LRTI (Lower Respiratory Tract Infection) (self-reported) p=0.022# p=0.044# LRTI worse cough severity LRTI worse cough related QoL Asthma (self-reported) p=0.021# p=0.054# asthma worse cough severity GORD (BRI questionnaire) p<0.0001# p<0.0001# GORD worse cough severity GORD worse cough related QoL Nausea (EORTC QLQ C30) p=0.004## p=0.017## Increased nausea worse cough severity. Increased nausea worse cough related QoL Oral Steroids p=0.434# p=0.017# On steroids worse cough related QoL Over the Counter Antitussives p=0.011# p=0.067# On antitussives worse cough severity Opiates p=0.497# p=0.018# On opiates worse cough related QoL *Not all analysed cough predictors shown # Mann-Whitney-U Test ## Kruskal-Wallis Test Conclusion
This is the largest single study to use validated cough-specific assessment tools in LC to characterise and assess potential influences on cough. LC patients have a severe cough, with comparable VAS scores to those of patients presenting to specialist chronic cough clinics. New antitussive therapies are needed. Key predictors of cough severity and reduced cough-specific QoL are performance status (PS), nausea and GORD. Preclinical research suggests that the neurokinin-1 pathway may mediate the vagal cough reflex pathway. Our results further support this hypothesis and imply that the neurokinin-1 pathway may be a relevant therapeutic target. The association with GORD may be explained by the shared vagal innervation of the airway and upper gastrointestinal tract.Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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O11.03 - The "CLiC" Cough in Lung Cancer Study: The Validation of Objective and Subjective Cough Assessment Tools in Lung Cancer Patients (ID 3006)
16:30 - 16:35 | Author(s): A.S.M. Harle, A. Molassiotis, J. Smith, F. Blackhall
- Abstract
Background
Cough is a common lung cancer (LC) symptom, yet effective therapies are lacking. The development and testing of novel therapies relies upon appropriate tools for the assessment of cough. CLiC is the first study to evaluate two new tools 1) objective ambulatory cough monitoring (ACM) from acoustic recordings (VitaloJAK™) and 2) the Manchester Cough in Lung Cancer Scale (MCLCS) quality of life (QoL) questionnaire. These provide complementary assessments of cough frequency and its impact upon the patient.Methods
Patients with LC and complaining of cough were recruited, irrespective of stage or treatment, from two cancer centres. Demographic and clinical data were collected. All patients completed the MCLCS, Cough Severity Diary (CSD) and cough severity Visual Analogue Scale (VAS). The European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ) C30 with the module (LC13), (including item 31: "In the past week, how often did you cough?") was also completed. The Common Toxicity Criteria for Adverse Events (CTCAEv4.0) was used to grade cough. A subgroup underwent ACM and MCLCS on Days 0&60.Results
We recruited 179 patients (Oct'11-Nov'12): median age 65yrs (range 25-83 years), 53% male. Majority (79%) had non small cell lung cancer, 60% advanced stage (>IIIA), 36% were on cancer therapy.Table showing correlations between subjective cough assessment tools EORTC QLQ C30 cough item 31 CTCAE Cough Grading MCLCS Manchester Cough LC Scale CSD Cough Severity Diary VAS Cough Severity 0.54**§ n=171 0.50**§ n=170 0.67**§ n=163 0.70**¥ n=84 EORTC QLQC-30 cough item Q31 0.45**§ n=173 0.57**§ n=165 0.52**§ n=85) CTCAE Cough Grading 0.56**§ n=164 0.59**§ n=85 MCLCS Manchester Cough LC Scale 0.76**¥ n=82 ** p<0.0001 ¥high correlation §moderate correlation
Intra-class correlations demonstrated good repeatability over time between Days 0&60 for cough frequency (24hour: r=0.77, p<0.0001, awake: r=0.79, p<0.0001, sleep: r=0.66, p=0.004) and MCLCS: r=067,p<0.001 .The median cough scores/hour were 14.1(24hour: range 0.7-156), 18.5 (awake: range 1-233) and 6.0 (asleep: range 0-110).Table showing correlations between objective ACM and subjective cough tools VAS Cough Severity MCLCS Manchester Cough LC Scale Log Cough/hr Asleep Log Cough/hr Awake Log Cough/hr 24-hour VAS Cough Severity 0.73** n=37 0.33* n=37 0.61** n=37 0.57** n=37 MCLCS Manchester Cough LC Scale 0.24 n=35 0.51* n=35 0.44* n=35 Log Cough/hr Asleep 0.52** n=35 0.62** n=35 Log Cough/hr Awake 0.97** n=37 ** p<0.0001 * p<0.05 Conclusion
We have demonstrated moderate to strong correlations between established measures of cough and two novel assessment tools, suggesting the validity of MCLCS and ACM. Their good repeatability suggests they have excellent potential for the assessment of novel treatments in future intervention studies for LC-related cough. In contrast, standard oncology tools are blunt and poorly discriminate cough. -
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- Abstract
- Presentation
Background
Patients with newly diagnosed advanced lung cancer may experience severe impacts on their quality of life (QOL). However, relatively few studies have examined the longitudinal patterns of QOL and their relationship to patients’ symptoms during the first 12 months of cancer diagnosis. Thus, the purposes of this study were to (1) examine the overall pattern and the potential sub-patterns (if any) of QOL in these patients during the first 12 months of cancer diagnosis; and (2) identify those important characteristics of each QOL sub-pattern and their relationship to patients’ symptoms.Methods
This is a 12-month prospective longitudinal study. Newly diagnosed advanced lung cancer patients (Stage IIIB & IV) were eligible to be recruited and followed for 12 months on 5 time points (Pre-treatment, 1, 3, 6 and 12 months since treatments). The overall QOL was measured by the overall QOL item in the EORTC QLQ-C30 (0-100 scoring, higher is better). The QOL patterns and factors related to the patterns were analyzed by Latent Class Growth Analysis (LCGA). Potential factors (independent variables) used to predict the overall QOL change and each QOL sub-pattern (dependent variables) included: physical function, selected symptoms, emotion distress, self-efficacy (on coping with cancer) and important demographic and treatment related variables.Results
A total of 200 subjects completed the 5 follow-up assessments. Generally, patients had moderate level of QOL across the 12 months. There were three QOL sub-patterns were identified. In the pattern I (around 50% of subjects), patients reported moderate to relatively good levels of QOL (scoring around 70-80) across the 12 months. In the pattern II (around 45% of subjects), patients reported moderate levels of QOL (scoring around 50-70 QOL). In the pattern III (<10% subjects), patients reported poor level of QOL (scoring around 40 or less). Overall, symptoms including fatigue, pain, lack of appetite and dyspnea were significantly related to the changes of QOL. Other factors also included psychological distress, uncertainty and self-efficacy (level of confidence) in coping well with lung cancer.Conclusion
The results provide a relatively comprehensive picture about the overall QOL and the sub-patterns of QOL for those newly diagnosed advanced lung cancer patients. The results further support the giving timing and tailoring interventions are needed to better improve lung cancer patients’ QOL. (Acknowledgement: National Health Research Institute,NHRI,Taiwan).Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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O11.05 - DISCUSSANT (ID 4006)
16:45 - 17:00 | Author(s): L. Morgan
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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O11.06 - The effects of inspiratory muscle training in the management of breathlessness in patients with lung cancer: a pilot feasibility randomized trial (ID 3179)
17:00 - 17:10 | Author(s): A. Molassiotis, A. Charalambous, P. Taylor, Z. Stamataki, Y.J. Summers
- Abstract
- Presentation
Background
Breathlessness in patients with lung cancer is common symptom affecting 50-70% of patients, rising to 90% for those with advanced lung cancer. Managing breathlessness is complex, treatment options are limited and treatments are sometimes unsuccessful. Inspiratory muscle training (IMT) is a non-pharmacological method that has shown positive results in Chronic Obstructive Pulmonary Disease and mixed results in other respiratory illnesses. As this treatment method has never been tested in patients with lung cancer, the aim of the current study was to assess how feasible this treatment is in the lung cancer population and explore changes in outcome variables, before launching a larger randomized trial.Methods
Pilot feasibility randomized trial in patients with lung cancer having stable disease. The experimental group received training using a pressure threshold device (commercially available from Phillips Respironics). Patients were instructed to do 5 sessions weekly for 12 weeks for a total of 30mins per day, divided over 2 sessions. Patients in the control group received standard care and received the treatment at the end of their trial participation. Outcome measures were completed at baseline and monthly for 3 months, and included: physiological parameters (FEV1,FVC); perceived severity of breathlessness in six 10-point VAS assessing average breathlessness over past 24 hours, worst breathlessness over past 24hrs, breathlessness now, distress from breathlessness, ability to cope with breathlessness and satisfaction with breathlessness management; modified Borg scale; quality of life using the short form-Chronic Respiratory Disease Questionnaire (with subscales on dyspnea, fatigue; emotional function and mastery of breathlessness); Hospital Anxiety & Depression Scale, and safety.Results
46 patients (M=37, F=9) at a mean age of 69.5 years old and a mean of 16 months post-diagnosis who were not currently receiving chemotherapy/radiotherapy were recruited from 3 centres in the UK and Cyprus. Seventy-percent had NSCLC and advanced disease. There were no changes in FEV1 and FVC levels between groups. There were time by intervention interaction effects in average breathlessness and worst breathlessness in past 24hrs (p<0.01) with the intervention arm showing stable breathlessness and the control group deteriorating, but no between-group differences. Statistical and clinically important differences were seen with regards to ability to cope with breathlessness (p=0.02), satisfaction with breathlessness management (p=0.024), fatigue (p=0.007), emotional function (p=0.006), breathlessness mastery (p=0.031), anxiety (p=0.027) and depression (p=0.048). The m-Borg difference between the 2 groups at 3 months was 0.80, which is borderline clinically significant but not statistically significant. Changes were more evident in the 3-month assessment. IMT was safe with only a small number of patients complaining of muscle fatigue and dizziness.Conclusion
This trial shows the IMT is feasible and safe in patients with lung cancer with significant benefits particularly in their ability to cope with breathlessness and emotional distress. The details of this trial allow us to refine the treatment protocol and findings guarantee a fully-powered larger trial (N should be around 196 with m-Borg as primary outcome).Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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- Abstract
- Presentation
Background
Central airway obstruction is seen in around 30% of patients with primary lung cancer. This is often a life-threatening presentation of the disease due to imminent airway loss and therefore requires urgent intervention. Direct bronchoscopic techniques including airway stenting can offer an immediate improvement in symptoms and quality of life, in addition to providing time for further treatment modalities. Here we report outcomes from a large single centre five year experience of tracheobronchial stent insertion for palliation of advanced primary lung cancer.Methods
A retrospective review of all patients undergoing tracheobronchial stent insertion between January 2007 and January 2012 was performed. Patients undergoing stent insertion for benign or secondary malignant disease were excluded. A total of 70 patients underwent 80 stenting procedures with an average age of 66 years. Patient notes were used to collect patient demographic, disease and stenting data. Outcomes included post-procedure length of stay, complications, need for further intervention and overall survival.Results
Disease was identified within the trachea in 18 cases, bilaterally within the bronchi in 10 cases and in the left or right bronchus in 23 and 28 cases respectively. Expandable, nitinol stents were used for all patients with either a proximal or distal release system. Uncovered stents (57), covered stents (20) or a mixture of the two (3) were placed. The average length of stay was 2.5 days (range 0-17); however, 69% of patients were discharged on the same day or on day one following the procedure. There were no cases of stent migration identified. The most common complication was retained secretions requiring repeat bronchoscopy which occurred in 5 cases. One patient required telescopic insertion of a second stent due to malposition of the first. Median survival was 2.6 months with a 20% one-year survival. There were 4 in hospital deaths.Conclusion
Central airway obstruction secondary to primary lung cancer can cause disabling dyspnoea and impending suffocation. Interventional bronchoscopic techniques, in particular airway stenting, can provide immediate relief of these symptoms. The survival data here reflects the advanced stage of disease in this patient group and, although unlikely to improve survival, airway stenting can offer the opportunity for further adjuvant treatment in some cases. More importantly perhaps, 91% of patients were discharged home following the procedure allowing an improved in quality of life. In our experience, tracheobronchial stent insertion can be used effectively to achieve these outcomes with minimal complications and a short hospital admission. Figure 1Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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- Abstract
Background
Tracheobronchial stent insertion is safe and effective in managing central airway obstruction in advanced lung carcinoma. Airway stenting offers both immediate relief of severe dyspnoea and time for adjuvant therapy. It is commonly used in specialist thoracic centres with a variety of stent models employed. A large number of centres still use fluoroscopic guidance for stent positioning, leading to increased radiation exposure for both patients and staff. The aim of this study was to compare outcomes in patients undergoing stent insertion with or without radiological guidance.Methods
70 patients were identified who underwent a total of 79 stent procedures. The cohort was divided into two groups based on whether stents were inserted under radiological guidance or direct vision at bronchoscopy. Retrospective analysis of notes was performed to collect data with regards to stenting strategy and post-operative course. The primary outcomes were length of stay, complications, repeat procedure and survival.Results
Of the 79 stent procedures, 41 were with radiological guidance (group 1) and 38 were under direct vision only (group 2). There was an equal distribution with regards to the position of the stents (Table 1). Both techniques were well tolerated with minimal complications and no stent migration. Post-procedure length of stay was 2.73 days in group 1 and 2.26 days in group 2, with no significant statistical difference seen (p=0.93). There was also no difference in need for further stent intervention. A comparison of survival is shown in Figure 1. Figure 1 Figure 2Conclusion
Airway stenting is a vital technique in the management of impending central airways obstruction. Although traditionally carried out under radiological guidance, we found no differences in complications, need for repeat procedure or survival when using direct vision. This not only saves radiation exposure to patients and staff, but also improves the cost-effectiveness and logistics of planning these urgent cases. -
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O11.09 - Ibandronic Acid vs. Zoledronic Acid In Lung Cancer Patients With Skeletal Metastases. How Do They Compare? (ID 90)
17:20 - 17:30 | Author(s): I.A. Dimitroulis, A. Dervas, S. Vasileiou, M. Toumbis
- Abstract
Background
Amino-biphosphonates are third-generation bisphosphonates which act by inhibition of osteoclasts. We have presented at two previous ATS conferences (Dimitroulis I.A. et al 2009, 2011), the role of each amino-biphosphonate separately. We set out to investigate the superiority or inferiority of Ibandronic acid (Ibandronate) over Zoledronic acid (Zoledronate), in terms of efficacy in reducing bone pain, and complications in patients with skeletal metastases due to Lung Cancer.Methods
Ninety six patients with Skeletal Metastases due to Lung Cancer were enrolled, and were randomized on a 1:1 basis to receive infusions of Ibandronate (50 pts) or Zoledronate (46 pts) intravenously, every 21 days. Infusion time for Zoledronate (4mg) was 15 minutes, and for Ibandronate (6mg) one hour. Patients (pts) were analysed for pain relief, skeletal-related events (SREs) and adverse events. All pts underwent dental and cardiac examination before enrollment, and completed blood tests every 21 days. Bone scan was performed every 6 months. Blood tests (including close monitoring of calcium levels and renal function) were performed before each amino-biphosphonate administration.Results
Patients in both arms were well matched for their diagnosis, stage of disease, burden of skeletal disease, and performance status. Median follow-up was 24 months. At 24 months, mean increases in British Pain Inventory pain scores were lower with Zoledronate compared to Ibandronate (0.43 vs 0.89 [p=0.03]). Analgesic effect as defined by the 4 point analgesic scale was less with Zoledronate as compared to Ibandronate. Incidence of SREs was not significantly different between two arms (35% for Zoledronate vs 38% for Ibandronate [p=0.2]). Median time to the first SRE was not reached in either arm. At 18 months of median follow up, percentages of patients with skeletal-related events were 41% in the Zoledronate arm vs 45% in the Ibandronate arm (p=0.05). Zoledronate caused fever in six (12%) patients and hypocalcemia in one patient. Ibandronate caused hypocalcemia in one patient (2.2%). No cases of jaw osteonecrosis, atrial fibrillation or renal failure (all of them possible side-effects of amino-biphosphonates) were observed.Conclusion
Zoledronate is the preferred amino-bisphosphonate for its shorter infusion time, availability and relative benefits. It is slightly better than Ibandronate in reducing bone pain and preventing skeletal-related events. The only possible drawback is that, locally, Zoledronate is 1.3 times more expensive than Ibandronate (according to the mean European Economic Community price). -
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O11.10 - DISCUSSANT (ID 4007)
17:30 - 17:45 | Author(s): A.B. Oton
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
Author of
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O11 - Symptom Management (ID 137)
- Event: WCLC 2013
- Type: Oral Abstract Session
- Track: Supportive Care
- Presentations: 1
- Moderators:B. Ivimey, I.N. Olver
- Coordinates: 10/28/2013, 16:15 - 17:45, Bayside Gallery A, Level 1
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O11.01 - Wiki-based treatment guidelines for lung cancer (ID 1274)
16:15 - 16:25 | Author(s): I.N. Olver
- Abstract
- Presentation
Background
The updating of written clincial practice guidelines regularly is difficult and expensive. New evidence in cancer treatment is published frequently. Guideline booklets are difficult to disseminate widely and stakeholder feedback is mainly pre-publication. To enable lung cancer guidelines to be rapidly updated and widely disseminated and therefore more likely to be utilised, Cancer Council Australia developed a web-based wiki platform for guidelines and is evaluating its impact.Methods
The initial methodology paralled the steps in published written guideline development but these were integrated with the wiki capability. An expert group, whose competing interests were documented, were identified, the key clinical questions and search strategies were developed for each question and literature searches recorded on the wiki. An online literature screening and critical appraisal process was developed. This provides data on which papers were used to form the guidelines and why papers were either selected or rejected depending on their quality. Evidence-based recommendations were formulated and evidence tables automatically generated. The wiki was closed in that only the invited experts could write or change a guideline but any stakeholder could comment on the guidelines at any time and the writing group would review and respond to comments. The initial vesion of the guidelines were distributed for targetted review by expert groups. We used web analytics to monitor usage. The writers remain engaged to appraise new papers and update the guideline rapidly as necessary. All previous versions could be accessed.Results
Evaluation of the lung caner treatment guidelines developed on the wiki, showed that 22 authors had identified 67 clinical questions covering treatment of all stages of lung cancer. The literature search and screening process resulted in 2035 potentially relevant articles being forwarded for detailed methodological evaluation with another 571 added through snowballing and other methods. To fine-tune the initial draft content, the working party used the wiki to exchange 156 internal comments in 9 weeks. When the guidelines were released for the initial 30-day public consultation period, 1055 users visited lung cancer content pages. The majority of users (487) accessed the guidelines directly as a result of targeted emails, while 387 found the site by Google searches. Most respondents were from Australia (799) and New Zealand (60) with the United States (47) having the largest user group of respondents from the other countries who visited the site. A survey of the usability of the site indicated widespread acceptance. The average time on a content page was 1:27minutes. The landing page was the most popular content page with 3426 page views and an exit rate of 18.85%, which indicates that the landing page served as an important tool for visitors to navigate the guidelines. To date there were 38 external comments which occasioned 31 edits by the working party.Conclusion
Adopting a platform built on MediaWiki, and moving to electronic guidelines has allowed rapid updates as new evidence becomes available and wider dissemination than print formats. The next strategy to boost uptake is to write Qstream education modules to accompany the guidelines.Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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O24 - Cancer Control and Epidemiology III (ID 134)
- Event: WCLC 2013
- Type: Oral Abstract Session
- Track: Prevention & Epidemiology
- Presentations: 1
- Moderators:N. Van Zandwijk, P. Yang
- Coordinates: 10/29/2013, 16:15 - 17:45, Bayside 103, Level 1
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O24.06 - DISCUSSANT (ID 4001)
17:05 - 17:20 | Author(s): I.N. Olver
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
