Health services research on cancer encompasses the entire continuum of cancer care, from prevention and early detection to diagnosis and treatment to survivorship and end-of-life care. Carolyn M. Clancy, M.D., Acting Director of the Agency for Healthcare Research and Quality, and William Lawrence, M.D., M.S., of AHRQ's Center for Outcomes and Effectiveness Research, discuss some lessons learned from cancer outcomes research in a recent article.
Outcomes researchers have developed practical approaches for assessing the impact of alternative treatments, including no treatment, and methods for soliciting patient judgments regarding the value of those outcomes. Work is in progress to develop consensus within the research community regarding which cancer outcome measures are most appropriate as required elements in future clinical trials. Unfortunately, interventions that have demonstrated effectiveness in a clinical trial do not always translate automatically into clinical practice. For example, despite the demonstrated effectiveness of colorectal cancer screening, only 44 percent of adults are screened according to the recommended timetable.
If definitive clinical trials are used to evaluate the relation between clinical process and health-related quality of life, the probability that they will be used in practice could increase dramatically, note the researchers. The cooperative Clinical Oncology Groups have long established relationships with community practices, primarily to increase enrollment of patients in clinical trials. These practices offer a fertile opportunity for identifying clinical questions relevant to practicing oncologists, conclude Drs. Clancy and Lawrence.
More details are in "Is outcomes research on cancer ready for prime time?" by Drs. Clancy and Lawrence, in Medical Care 40(6, suppl), pp. 92-100.
Reprints (AHRQ Publication No. 02-R075) are available from the AHRQ Publications Clearinghouse and AHRQ InstantFax.