The following is a research notebook entry. Skip it if you’re not a prostate cancer wonk (or wonk wannabe).
From “Quality of prostate cancer care among rural men in the Veterans Health Administration,” by Skolarus et al. (Cancer, 2013):
- “Disease risk was classified into low, intermediate, and high risk according to D’Amico criteria.” [Link added.]
- “On the basis of a 2005 VA facility survey of oncology resources (138 facilities), [*] we characterized each facility according to the following characteristics that might influence selected measures of quality prostate cancer care: American College of Surgeons Commission on Cancer certification; onsite cancer registrar; prostate cancer cases discussed at a tumor board; urologist, medical, and radiation oncology staffing; onsite prostate pathology services, chemotherapy, radiation therapy, and palliative care services.”
- “We selected 5 quality measures for prostate cancer care. […] These included: 1) at least 10 core samples taken at prostate needle biopsy, 2) no bone scan before primary therapy for prostate cancer at low risk of recurrence, 3) central axis external-beam radiation therapy doses of at least 75 Gy, 4) administration or documented discussion of docetaxel-based chemotherapy for castration-resistant prostate cancer, and 5) neoadjuvant and/or adjuvant hormone therapy for high-risk patients receiving external beam radiation therapy. […] Data used to calculate these indicators were collected remotely from the electronic medical record by trained medical abstractors using a VA contractor .”
- “Rural patients were significantly less likely to be treated at facilities with comprehensive cancer resources, although they received a similar or better quality of care for 4 of the 5 prostate cancer quality measures. The time to prostate cancer treatment was similar (rural patients vs urban patients, 96.6 days vs 105.7 days).”
* Program Evaluation of Oncology Programs in the Veterans Health Administration, Survey of Department of Veterans Affairs Medical Centers. Office of Policy, Planning, and Preparedness. Final Report, March 2006. Cambridge, MA: Abt Associates Inc., Harvard Medical School; 2006.