Virtual Library
Start Your Search
Nicole Marion Rankin
Author of
-
+
P3.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 722)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P3.06-008 - Lung Cancer Pathways: A Five-Year Program to Reduce Impact Through Epidemiological Modelling and Investment in Prioritized Interventions (ID 9858)
09:30 - 09:30 | Presenting Author(s): Nicole Marion Rankin
- Abstract
Background:
Pathways is a five-year program of targeted research to identify and implement those interventions that will have the greatest impact in reducing lung cancer incidence and mortality, and improving quality of life. It includes a sharply-focused research program to identify relevant interventions and health actions, a consultative phase with national and international experts to prioritise ‘best value’ interventions, whilst considering the broader political and economic issues around implementation and policy change. A final decision and investment stage will direct funding and research activities to implement the ‘best value’ interventions in lung cancer prevention, screening, early intervention, treatment and supportive care.
Method:
A microsimulation model (‘Policy1’) has been designed using a powerful, flexible platform that can be programmed with information about multiple aspects of lung cancer to formulate an evidence base for determining the ‘best value’ interventions by comparing the impact and costs of interventions. These aspects include the ‘natural history’ of the disease, prevention actions (including tobacco control and lifestyle interventions), individual risk factors and screening behaviours, and cancer treatment type and uptake in various population subgroups. Policy1 is informed by work programs in statistical projections of lung cancer mortality (based on available mortality data and Australian smoking survey data), systematic reviews, big data and epidemiological analysis, and implementation science, to address health behaviour change and contextual factors. A Scientific Advisory Committee (SAC) of key stakeholders provides content expertise and strategic advice about pursuing detailed analyses selected interventions.
Result:
The statistical projections program indicates that lung cancer mortality rates for males will continue to decline and plateau after 2035, while for females, the mortality rate is expected to decrease steadily after 2014. Data from over sixty years of Australian tobacco smoking surveys has been used to estimate smoking prevalence, tobacco consumption, quit rates and duration of smoking. Seven scoping reviews have been completed in the areas of preventative strategies, early diagnosis, treatment regimens and clinical practice guidelines, health services interventions, psychosocial and palliative care. Key questions have been formulated and presented to the SAC to guide selection of ‘best value’ interventions for detailed exploration.
Conclusion:
Pathways presents an innovative approach to addressing those interventions that are likely have the greatest impact on improving lung cancer outcomes. The program will make a significant contribution to reducing the burden of illness in the Australian population by engaging with key stakeholders, guiding future research priorities, and translating research evidence into action.
-
+
P3.13 - Radiology/Staging/Screening (ID 729)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P3.13-038 - The RoaDmaP Study: Feasibility of Implementing a Primary Care Intervention for Referral of Potential Lung Cancer Cases to Specialist Care (ID 9875)
09:30 - 09:30 | Presenting Author(s): Nicole Marion Rankin
- Abstract
Background:
Pathways to lung cancer diagnosis are complex. General Practitioners (GPs) play a vital role in ensuring that people diagnosed with lung cancer receive timely access to appropriate specialist care. Australian guidelines recommend that the first specialist appointment should take place within two weeks of the initial GP referral. However, local data indicate that up to 60% of patients are not referred within two weeks, while state-based data shows that 11% of patients in New South Wales (NSW), Australia, do not see a lung cancer specialist at all; these patients may be missing out on curative and palliative treatments. We designed a primary care intervention to address these gaps and conducted a feasibility study in three sites across NSW. The RoaDmaP pilot study aimed to develop, implement and evaluate the Referral Decision Prompt (RDP), an intervention that supports GPs to refer patients with a suspicious lung lesion on CT scan for specialist care. Specific objectives were to evaluate feasibility and acceptability with GPs, radiologists and radiology practice staff.
Method:
The RDP intervention was developed with key stakeholder input and was tailored for three participating radiology practices. Eligibility criteria included any patient aged over 18 attending for a chest CT scan. Recruitment and consent procedures were tested to enable collection of patient’s medical data from GPs and hospitals to confirm lung cancer diagnoses. The RDP template was integrated into CT scan reports for patients with a suspicious lung lesion. A process evaluation with GPs, radiologists and radiology staff was undertaken through brief surveys and qualitative focus groups.
Result:
Over seven months, 445 patients had a GP-referred chest CT scan; 400 were given study documents; 293 consented (73%). Twelve patients had a suspicious lesion, eight of whom received a confirmed lung cancer diagnosis. Sixty-six percent had a specialist appointment within two weeks. The intervention was rated as highly acceptable by radiologists, radiographers and practice staff; four GPs participated in the evaluation, three recalled the RDP and two used it to change their referral practices.
Conclusion:
The RoaDmaP study presents an innovative approach to identifying lung cancer patients prior to diagnosis and has the potential to improve timely and appropriate specialist referral. The process evaluation findings indicate that this simple, low-cost intervention is feasible and can be easily integrated into radiology reporting practices. It is highly acceptable to radiologists and practice staff, and may positively influence GP referral practices.
