Cancer diagnostic assessment programs: standards for the organization of care in Ontario

[摘要] Background: While improving access to better, more efficient, rapid cancer diagnoses is a necessary component to a high-quality cancer system, how the diagnostic services ought to be organized, structured and evaluated is less understood and studied.Methods: This project was undertaken as a quality initiative of Cancer Care Ontario’s Program in Evidence-based Care. An expert panel, with representation from clinical oncology experts, institutional and clinical administrative leaders, health service researchers, and methodologists, conducted a systematic review and environmental scan of the unpublished literature. Standards were developed based upon expert consensus opinion informed by evidence from 35 published studies and 15 unpublished guidance documents. Clinicians and administrators across Ontario were given the opportunity for feedback through external review. Results: Organized centralized systems with multidisciplinary team membership are considered the optimum organization for the delivery of diagnostic cancer assessment services. Even though much of the available literature is limited in quantity and quality, and expert consensus opinion was often used to inform the standards, both the evidence and consensus opinion indicate a consistent message across studies and other credible guidance organizations. Interpretation: Based upon the best available evidence, standards for the organization of diagnostic assessment programs are offered. There is clear need to integrate formal and comprehensive evaluation strategies with the implementation of the standards to advance this field.

[学科分类] 肿瘤学