Initiatives for education, training, and dissemination of morbidity assessment and reporting in a multiinstitutional international context: Insights from the EMBRACE studies on cervical cancer.


Journal

Brachytherapy
ISSN: 1873-1449
Titre abrégé: Brachytherapy
Pays: United States
ID NLM: 101137600

Informations de publication

Date de publication:
Historique:
received: 29 05 2020
revised: 17 07 2020
accepted: 11 08 2020
pubmed: 27 9 2020
medline: 2 6 2021
entrez: 26 9 2020
Statut: ppublish

Résumé

In 2008, the GEC ESTRO Gyn network launched the first multiinstitutional, observational, and prospective international study on MRI-guided brachytherapy in locally advanced cervical cancer patients (EMBRACE-I). EMBRACE-I was followed by EMBRACE-II from 2016 and ongoing. Among the aims of the EMBRACE studies are to benchmark morbidity outcomes and develop dose-volume effects and predictive models for morbidity. The EMBRACE studies collect both physician (CTCAE v.3) and patient (EORTC QLQ-C30/CX24) reported outcomes, including baseline information, in a regular follow-up schedule. The EMBRACE studies feature high numbers of patients (EMBRACE-I N = 1416, EMBRACE-II N = 1500 expected) enrolled from many institutions worldwide (EMBRACE-I n = 23, EMBRACE-II n = 45). This large-scale multiinstitutional approach offers a unique opportunity to investigate and develop new strategies for improving the quality of assessment and reporting of morbidity. This report presents an overview of the challenges and pitfalls regarding the assessment and reporting of morbidity encountered during more than a decade of development and research activities within the EMBRACE consortium. This includes the recognition and evaluation of inconsistencies in the morbidity assessment, and consequently, the provision of assistance and training in the scoring procedure to reduce systematic assessment bias. In parallel, a variety of methodological approaches were tested to comprehensively summarize morbidity outcomes, and a novel approach was developed to refine dose-effect models and risk factor analyses. The purpose of this report is to present an overview of these findings, describe the learning process, and the strategies that have consequently been implemented regarding educational activities, training, and dissemination.

Identifiants

pubmed: 32978080
pii: S1538-4721(20)30186-0
doi: 10.1016/j.brachy.2020.08.011
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

837-849

Informations de copyright

Copyright © 2020 American Brachytherapy Society. All rights reserved.

Auteurs

Kathrin Kirchheiner (K)

Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. Electronic address: kathrin.kirchheiner@meduniwien.ac.at.

Stéphanie Smet (S)

Department of Radiation Oncology, AZ Turnhout, Turnhout, Belgium.

Sofia Spampinato (S)

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.

Nina B K Jensen (NBK)

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.

Anders Schwartz Vittrup (AS)

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.

Lars Fokdal (L)

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.

Dina Najjari-Jamal (D)

Department of Radiation Oncology, Catalan Institute of Oncology, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.

Henrike G Westerveld (HG)

Department of Radiation Oncology, Amsterdam University Medical Centers, AMC, Amsterdam, the Netherlands.

Jacob C Lindegaard (JC)

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.

Christian Kirisits (C)

Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Astrid De Leeuw (A)

Department of Radiation Oncology, University Medical Center, Utrecht, the Netherlands.

Maximilian P Schmid (MP)

Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Li Tee Tan (LT)

Department of Oncology, Cambridge University Hospitals, Cambridge, UK.

Remi A Nout (RA)

Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands.

Ina M Jürgenliemk-Schulz (IM)

Department of Radiation Oncology, University Medical Center, Utrecht, the Netherlands.

Richard Pötter (R)

Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Kari Tanderup (K)

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.

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