The rare reality of COVID-19

The rare reality of COVID-19
Genetic Alliance 2 July 2020

• People living with rare conditions have been placed under immense pressure by the Covid-19 pandemic. Access to appropriate support, information, care and treatments has become more difficult and levels of social isolation have been increased. This report presents findings from the EURORDIS Rare Barometer Covid-19 Experience Survey, and from Generic Alliance weekly community meetings during the months of April, May and June 2020.

Tele-oncology in the COVID-19 Era: The Way Forward?

Tele-oncology in the COVID-19 Era: The Way Forward?
Trends Cancer. 2020;6(7):547-549. doi:10.1016/j.trecan.2020.05.013

• COVID-19 has had a devastating impact on the care of cancer patients. Thus, tele-oncology has become a necessity to improve cancer care. Several organisations have issued guidelines for its use during COVID-19. Despite certain shortcomings, tele-oncology has great potential to help cancer patients during COVID-19 and in the future.
• Table 1: Summary of the Advantages and Disadvantages of Telehealth Technologies in Oncology

Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies

Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies
Anaesthesia 30 June 2020 https://doi.org/10.1111/anae.15201

• A literature search identified 4 articles which reported ICU outcome data for patients admitted to ICU with a COVID-19 diagnosis (n=10,150). The largest patient group was in the Intensive Care National Audit and Research Centre (ICNARC) study from the UK. 
• In patients with completed ICU admissions with COVID-19 infection, combined ICU mortality was 41.6% (95%CI 34.0-49.7%, I2 = 93.2%). Subgroup analysis by continent showed that mortality is broadly consistent across the globe. The in-ICU mortality from COVID-19 is higher than usually seen in ICU admissions with other viral pneumonias. The mortality from completed episodes of ICU differs considerably from the crude mortality rates in some early reports.

Summary

National Bowel Cancer Audit Short Report

National Bowel Cancer Audit Short Report
HQIP 11 June 2020

Patient Reported Experience Measures
The aim of this short report was to link the CPES responses to the National Bowel Cancer Audit (NBOCA) data to explore the feasibility of reporting PREMs at hospital trust level in a cohort of newly diagnosed colorectal cancer patients admitted to hospital in England for initial treatment of their cancer.

Cancer registry data
This report aims to understand the reasons for the differences in cases captured in the two datasets National Cancer Registration and Analysis Service (NCRAS) and the National Bowel Cancer Audit (NBOCA) data. And to determine whether NCRAS data can be routinely linked to audit data to improve case ascertainment in audit reporting.

National Oesophago-Gastric Cancer Audit – Short Report 2020

National Oesophago-Gastric Cancer Audit – Short Report 2020
HQIP 11 June 2020

• This report details the results of a comparison into how the cohort of patients with epithelial oesophago-gastric cancer in the National Oesophago-Gastric Cancer Audit (NOGCA) compares with the population of OG cancer captured by the English cancer registration process.

Removing hospital-based triage from suspected colorectal cancer pathways: the impact and learning from a primary care-led electronic straight-to-test pathway

Removing hospital-based triage from suspected colorectal cancer pathways: the impact and learning from a primary care-led electronic straight-to-test pathway
BMJ Quality & Safety 11 June 2020. doi: 10.1136/bmjqs-2019-009975

• An electronic straight to test pathway for suspected colorectal cancer was introduced allowing GPs to book tests supported by a decision aid based on NICE guidance eliminating the need for a standard referral form or triage process. 
• Analysis of 11357 patients over 3 years found  that time from referral to diagnosis reduced from 39 to 21 days and led to a dramatic improvement in patients starting treatment within 62 days. Challenges included adapting to a change in referral criteria and developing a robust hospital system to monitor the pathway.

Abstract

Implementing major system change in specialist cancer surgery: The role of provider networks.

Implementing major system change in specialist cancer surgery: The role of provider networks.
Journal of Health Services Research & Policy. 7 June 2020  doi.org/10.1177/1355819620926553

• This study used the case of centralization of specialist cancer surgery in London, UK to develop new understanding of the role that networks can play in implementing major system change. 
• Part of the RESPECT-21 programme. [2 page summary]

Abstract

Threshold for Computer- and Robot-Assisted Knee and Hip Replacements in the English NHS

Threshold for Computer- and Robot-Assisted Knee and Hip Replacements in the English National Health Service.
Value Health. 2020;23(6):719-726. doi:10.1016/j.jval.2019.11.011

• This study provides estimates of threshold prices for a range of potential improvements in the effectiveness of knee and hip replacement that could be realised from the adoption of computer- and robot-assisted knee and hip replacement.
• At a cost-effectiveness threshold of £20 000 per additional quality-adjusted life-year (QALY), the threshold price for a 5% improvement in post-primary unrevised quality of life (approximately equivalent to an additional two points in postoperative Oxford Knee Score [OKS]/Oxford Hip Score [OHS]) would be £10 000. The threshold price for a 50% reduction in the risk of revision would be £1000 per procedure.

Abstract

Cost-effectiveness of Surgical Comanagement: A Systematic Review

Cost-effectiveness of Surgical Comanagement: A Systematic Review

Surgeon 2020 Apr 26;S1479-666X(20)30045-7. doi: 10.1016/j.surge.2020.04.001

• A search for research into the impact of surgical comanagement programmes on healthcare costs identified 8 studies, five of which reported savings while three three reported increased costs. Seven of the studies reported decreases in length of stay.

Abstract

Some patients with suspected cancer fail to attend referral appointments – we found out why

Some patients with suspected cancer fail to attend referral appointments – we found out why
The Conversation 28 November 2019

• A study has found evidence that more than 5% patients do not attend their urgent referral appointments. The researchers used a statistical study of more than 100,000 patients who had received an urgent referral for suspected cancer, and an interview study with GPs and with patients who had cancelled or not attended their urgent referral appointment to try to understand why.