ArticleBMC health services research2012
Clinicians' adherence versus non adherence to practice guidelines in the management of patients with sarcoma: a cost-effectiveness assessment in two European regions.
Article in BMC health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinicians' attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature.Implementation science : IS · 2020Pooled it
- [Unplanned excision of extremity and superficial trunk soft tissue sarcomas].Chirurgie (Heidelberg, Germany) · 2023Article
- Multidisciplinary management of adolescents and young adults (AYA) sarcoma: A successful effort of an adult high-volume cancer center.Cancer medicine · 2023Article
- Ten recommendations for sarcoma surgery: consensus of the surgical societies based on the German S3 guideline "Adult Soft Tissue Sarcomas".Langenbeck's archives of surgery · 2023Article
- Article
- Designing rare disease care pathways in the Republic of Ireland: a co-operative model.Orphanet journal of rare diseases · 2022Article
- Poorly-differentiated and undifferentiated sarcomas of the mediastinum: a bag of tricks.Mediastinum (Hong Kong, China) · 2021Review
- Article
- Let there be Guidance!!!Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
- Conformity to Clinical Practice Guidelines at Initial Management in Adult Soft Tissue and Visceral Tumors since the Implementation of the NetSarc Network in Eastern France.The oncologist · 2019Article
- Surgery in reference centers improves survival of sarcoma patients: a nationwide study.Annals of oncology : official journal of the European Society for Medical Oncology · 2019Article
- [Principles of sarcoma surgery].Der Pathologe · 2019Review
- [Systematic planning of surgery for soft tissue sarcoma of the extremities].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2019Review
- Impact of the World Health Organization Pain Treatment Guidelines and the European Medicines Agency Safety Recommendations on Nonsteroidal Anti-Inflammatory Drug Use in Lithuania: An Observational Study.Medicina (Kaunas, Lithuania) · 2018Observational
- Improved survival using specialized multidisciplinary board in sarcoma patients.Annals of oncology : official journal of the European Society for Medical Oncology · 2017Article
- Adherence to Guidelines for Adult (Non-GIST) Soft Tissue Sarcoma in the Netherlands: A Plea for Dedicated Sarcoma Centers.Annals of surgical oncology · 2017Article
- Cost effectiveness of adherence to IDSA/ATS guidelines in elderly patients hospitalized for Community-Aquired Pneumonia.BMC medical informatics and decision making · 2016Observational
- Transferability of health cost evaluation across locations in oncology: cluster and principal component analysis as an explorative tool.BMC health services research · 2014Article
- Territorial inequalities in management and conformity to clinical guidelines for sarcoma patients: an exhaustive population-based cohort analysis in the Rhône-Alpes region.International journal of clinical oncology · 2014Article
- [Interdisciplinary treatment of soft tissue sarcoma of the extremities].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2014Review
Corrections and comments
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Authors and funding
18 authors.
Funding
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Abstract
backgroundAlthough the management of sarcoma is improving, non adherence to clinical practice guidelines (CPGs) remains high, mainly because of the low incidence of the disease and the variety of histological subtypes. Since little is known about the health economics of sarcoma, we undertook a cost-effectiveness analysis (within the CONnective TIssue CAncer NETwork, CONTICANET) comparing costs and outcomes when clinicians adhered to CPGs and when they did not.
methodsPatients studied had a histological diagnosis of sarcoma, were older than 15 years, and had been treated in the Rhône-Alpes region of France (in 2005/2006) or in the Veneto region of Italy (in 2007). Data collected retrospectively for the three years after diagnosis were used to determine relapse free survival and health costs (adopting the hospital's perspective and a microcosting approach). All costs were expressed in euros (€) at their 2009 value. A 4% annual discount rate was applied to both costs and effects. The incremental cost-effectiveness ratio (ICER) was expressed as cost per relapse-free year gained when management was compliant with CPGs compared with when it was not. To capture uncertainty surrounding ICER, a probabilistic sensitivity analysis was performed based on a non-parametric bootstrap method.
resultsA total of 219 patients were included in the study. Compliance with CPGs was observed for 118 patients (54%). Average total costs reached 23,571 euros when treatment was in accordance with CPGs and 27,313 euros when it was not. In relation to relapse-free survival, compliance with CPGs strictly dominates non compliance, i.e. it is both less costly and more effective. Taking uncertainty into account, the probability that compliance with CPGs still strictly dominates was 75%.
conclusionsOur findings should encourage physicians to increase their compliance with CPGs and healthcare administrators to invest in the implementation of CPGs in the management of sarcoma.
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