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Comparative Effectiveness Of Therapies For Clinically Localized Prostate Cancer
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Book Synopsis Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer by :
Download or read book Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer written by and published by . This book was released on 2008 with total page 187 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report summarizes evidence comparing the relative effectiveness and safety of treatment options for clinically localized prostate cancer. The report addresses the following questions: what are the comparative risks, benefits, short- and long-term outcomes of therapies for clinically localized prostate cancer? How do specific patient characteristics, e.g., age, race/ethnicity, presence or absence of comorbid illness, preferences (e.g., tradeoff of treatment-related adverse effects vs. potential for disease progression), affect the outcomes of these therapies, overall and differentially? How do provider/hospital characteristics affect outcomes overall and differentially (e.g., geographic region and volume)? How do tumor characteristics, e.g., Gleason score, tumor volume, screen vs. clinically detected tumors, affect the outcomes of these therapies, overall and differentially?--resource home page.
Author :U. S. Department of Health and Human Services Publisher :CreateSpace ISBN 13 :9781490543284 Total Pages :188 pages Book Rating :4.5/5 (432 download)
Book Synopsis Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer by : U. S. Department of Health and Human Services
Download or read book Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-26 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prostate cancer is the most common nondermatologic cancer in men. In 2007 an estimated 218,890 men were diagnosed with, and 27,050 deaths were attributed to, prostate cancer in the United States. Approximately 90 percent of men with prostate cancer have disease considered confined to the prostate gland (clinically localized disease). Reported prostate cancer incidence has increased with introduction of the prostate-specific antigen (PSA) blood test. Disease specific mortality rates have declined, and an estimated 1.8 million men living in the United States have a diagnosis of prostate cancer. Clinically detected prostate cancer is primarily a disease of elderly men. Prostate cancer frequently has a relatively protracted course even if left untreated, and many men die with, rather than from, prostate cancer. Largely because of widespread PSA testing, the lifetime risk of being detected with prostate cancer in the United States has nearly doubled to 20 percent. However, the risk of dying of prostate cancer has remained at approximately 3 percent. Therefore, considerable overdetection and treatment may exist. The primary goal of treatment is to target the men most likely to need intervention in order to prevent prostate cancer death and disability while minimizing intervention-related complications. Common treatments include watchful waiting (active surveillance), surgery to remove the prostate gland (radical prostatectomy), external beam radiotherapy (EBRT) and interstitial radiotherapy (brachytherapy), freezing the prostate (cryotherapy), and androgen deprivation therapy (ADT). All treatments have risks of complications, although frequency and severity may vary. Patient treatment decisionmaking incorporates physician recommendations and estimated likelihood of cancer progression without treatment, as well as treatment-related convenience, costs, and potential for eradication and adverse effects (AEs). Patient characteristics, including race/ethnicity, age, and comorbidities, have an important role in predicting mortality; the likelihood of treatment-related urinary, bowel, and sexual dysfunction; treatment tradeoff preferences; and selection. However, little is known about how these characteristics modify the effect of treatment. Prior to the advent of widespread PSA testing, most prostate cancers were detected based on abnormalities on the digital rectal examination (DRE) or incidentally from tissue obtained at surgery for treatment of symptoms due to benign prostatic obstruction. The vast majority of prostate cancers currently detected in the United States are asymptomatic, clinically localized, and found on routine PSA testing. PSA testing detects more tumors, at an earlier stage, with smaller volume within each stage, and at an earlier period in a man's life than non-screen detected tumors. The clinical significance, natural history, and comparative effectiveness of treatments in PSA-detected cancers are not known but likely differ from those detected and treated in the pre-PSA era (before the late 1980s to early 1990s). This report summarizes evidence comparing the relative effectiveness and safety of treatment options for clinically localized prostate cancer. The report addresses the following questions: 1. What are the comparative risks, benefits, short- and long-term outcomes of therapies for clinically localized prostate cancer? 2. How do specific patient characteristics, e.g., age, race/ethnicity, presence or absence of comorbid illness, preferences (e.g., tradeoff of treatment-related adverse effects vs. potential for disease progression), affect the outcomes of these therapies, overall and differentially? 3. How do provider/hospital characteristics affect outcomes overall and differentially (e.g., geographic region and volume)? 4. How do tumor characteristics, e.g., Gleason score, tumor volume, screen vs. clinically detected tumors, affect the outcomes of these therapies, overall and differentially?
Book Synopsis Comparative Evaluation of Radiation Treatments for Clinically Localized Prostate Cancer by : Stanley Ip
Download or read book Comparative Evaluation of Radiation Treatments for Clinically Localized Prostate Cancer written by Stanley Ip and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The Coverage and Analysis Group at the Centers for Medicare and Medicaid Services (CMS) requested this report from The Technology Assessment Program (TAP) at the Agency for Healthcare Research and Quality (AHRQ). AHRQ assigned this report to the following Evidence-based Practice Center: Tufts EPC (Contract No. 290 2007 10055 I). Prostate cancer is the most common noncutaneous malignancy diagnosed in men in the United States. The vast majority of patients diagnosed today have clinically localized prostate cancer (T1-T2N0), which is the subject of this report. A Comparative Effectiveness Review of Therapies for Clinically Localized Prostate Cancer was undertaken on behalf of the Agency for Healthcare Research and Quality (AHRQ) by the Minnesota Evidence-based Practice Center (EPC) in 2007 (Wilt et al. Comparative effectiveness of therapies for clinically localized prostate cancer. Comparative Effectiveness Review No. 13, prepared by Minnesota Evidence-based Practice Center under contract no. 290-02-0009 Rockville, MD: Agency for Healthcare Research and Quality, February 2008. Available at effectivehealthcare.ahrq.gov/reports/final.cfm). The report concluded that "No one therapy can be considered the preferred treatment for localized prostate cancer due to limitations in the body of evidence as well as the likely tradeoffs an individual patient must make between estimated treatment effectiveness, necessity, and adverse effects. All treatment options result in adverse effects (primarily urinary, bowel, and sexual), although the severity and frequency may vary between treatments. Even if differences in therapeutic effectiveness exist, differences in adverse effects, convenience, and costs are likely to be important factors in individual patient decision making." As more studies on radiation treatments have been published since the Minnesota report, the Centers for Medicare and Medicaid Services (CMS) is interested in an update. After consultation with AHRQ and CMS, this technology assessment has been commissioned specifically to examine the recent comparative studies on radiation treatments of clinically localized prostate cancer.
Author :U. S. Department of Health and Human Services Publisher :Createspace Independent Pub ISBN 13 :9781484974209 Total Pages :108 pages Book Rating :4.9/5 (742 download)
Book Synopsis Future Research Needs for Comparative Effectiveness of Treatments of Localized Prostate Cancer by : U. S. Department of Health and Human Services
Download or read book Future Research Needs for Comparative Effectiveness of Treatments of Localized Prostate Cancer written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-05-14 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: An estimated 1.8 million men living in the United States have a diagnosis of prostate cancer, with about 218,890 newly diagnosed men each year. Approximately 90 percent of men with prostate cancer have disease considered confined to the prostate gland (i.e., clinically localized disease). If left untreated, frequently men die with, rather than from, prostate cancer. Largely because of widespread prostate-specific antigen (PSA) testing, the lifetime risk of prostate cancer diagnosis in the United States has nearly doubled to 20 percent, while the risk of dying of prostate cancer has remained at approximately 3 percent. Therefore, considerable over detection and treatment may exist. Moreover, the treatment of localized prostate cancer is associated with substantial adverse effects. The primary goal of treatment is to target those men most likely to need intervention to prevent prostate cancer death and disability, while minimizing intervention-related complications. Common treatments include watchful waiting (active surveillance), surgery to remove the prostate gland (i.e., radical prostatectomy), radiotherapy (e.g., external-beam radiation or brachytherapy), freezing the prostate (i.e., cryotherapy), and androgen-deprivation therapy (ADT). All treatments for prostate cancer have risks of complications, although their frequency and severity may vary. Common adverse events include urinary, bowel, and sexual dysfunction. The vast majority of prostate cancers currently detected in the United States are asymptomatic, clinically localized, and found on routine PSA testing. PSA testing detects more tumors, at an earlier stage, with a smaller volume within each stage, and at an earlier period in a man's life than nonscreen-detected tumors. The clinical significance, natural history, and comparative effectiveness of treatments in PSA-detected cancers are not known but likely differ from those detected and treated in the pre-PSA era (before the late 1980s to early 1990s). The objective of this project is to pilot an approach for developing future research priorities and suggesting specific projects to address evidence gaps. From the results of this and comparable pilot projects conducted by other Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers (EPCs), AHRQ will identify generalizable strategies and lessons learned. The topic of this pilot project, the comparative effectiveness of treatments for localized prostate cancer, was selected because of its importance. The Minnesota EPC completed a comparative effectiveness review (CER) on this topic in 2008 for AHRQ. This pilot project amends the list of recommendations from that report and creates prioritized lists of research gaps and proposed research studies. Subsequently, management strategies for local prostate cancer were in the first quartile of the Institute of Medicine's 100 initial priority topics for comparative effectiveness research: Compare the effectiveness of management strategies for localized prostate cancer (e.g., active surveillance, radical prostatectomy [conventional, robotic, and laparoscopic], and radiotherapy [conformal, brachytherapy, proton beam, and intensity-modulated radiotherapy]) on survival, recurrence, side effects, quality of life, and costs.
Book Synopsis Future Research Needs for Comparative Effectiveness of Treatments of Localized Prostate Cancer by :
Download or read book Future Research Needs for Comparative Effectiveness of Treatments of Localized Prostate Cancer written by and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The objective of this project is to pilot an approach for developing future research priorities and suggesting specific projects to address evidence gaps. From the results of this and comparable pilot projects conducted by other Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers (EPCs), AHRQ will identify generalizable strategies and lessons learned. The topic of this pilot project, the comparative effectiveness of treatments for localized prostate cancer, was selected because of its importance. The Minnesota EPC completed a comparative effectiveness review (CER) on this topic in 2008 for AHRQ. This pilot project amends the list of recommendations from that report and creates prioritized lists of research gaps and proposed research studies. Subsequently, management strategies for local prostate cancer were in the first quartile of the Institute of Medicine's 100 initial priority topics for comparative effectiveness research.
Book Synopsis Therapies for Clinically Localized Prostate Cancer by : Philipp Dahm
Download or read book Therapies for Clinically Localized Prostate Cancer written by Philipp Dahm and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: To update findings from previous Agency for Healthcare Research and Quality (AHRQ)- and American Urological Association (AUA)-funded reviews evaluating therapies for clinically localized prostate cancer (CLPC). SOURCES: Bibliographic databases (2013-January 2020); ClinicalTrials.gov; systematic reviews METHODS: Controlled studies of CLPC treatments with duration ≥5 years for mortality and metastases and ≥1 year for quality of life and harms. One investigator rated risk of bias (RoB), extracted data, and assessed certainty of evidence; a second checked accuracy. We analyzed English-language studies with low or medium RoB. We incorporated findings from randomized controlled trials (RCTs) identified in the prior reviews if new RCTs provided information on the same intervention comparison. RESULTS: We identified 67 eligible references; 17 were unique RCTs. Among clinically rather than prostate-specific antigen (PSA) detected CLPC, Watchful Waiting (WW) may increase mortality and metastases versus Radical Prostatectomy (RP) at 20+ years. Urinary and erectile dysfunction were lower with WW versus RP. WW's effect on mortality may vary by tumor risk and age but not by race, health status, comorbidities, or PSA. Active Monitoring (AM) probably results in little to no difference in mortality in PSA-detected CLPC versus RP or external beam radiation (EBR) plus Androgen Deprivation (AD) regardless of tumor risk. Metastases were slightly higher with AM. Harms were greater with RP than AM and mixed between EBR plus AD versus AM. 3D-conformal EBR and AD plus low-dose-rate brachytherapy (BT) provided a small reduction in all-cause mortality versus three-dimensional conformal EBR and AD but little to no difference on metastases. EBR plus AD versus EBR alone may result in a small reduction in mortality and metastases in higher risk disease but may increase sexual harms. EBR plus neoadjuvant AD versus EBR plus concurrent AD may result in little to no difference in mortality and genitourinary toxicity. Conventionally fractionated EBR versus ultrahypofractionated EBR may result in little to no difference in mortality and metastases and urinary and bowel toxicity. Active Surveillance may result in fewer harms than photodynamic therapy and laparoscopic RP may result in more harms than robotic-assisted RP. Little information exists on other treatments. No studies assessed provider or hospital factors of RP comparative effectiveness. CONCLUSIONS: RP reduces mortality versus WW in clinically detected CLPC but causes more harms. Effectiveness may be limited to younger men or to those with intermediate-risk disease and requires many years to occur. AM results in little to no mortality difference versus RP or EBR plus AD. EBR plus AD reduces mortality versus EBR alone in higher risk CLPC but may worsen sexual function. Adding low-dose-rate BT to 3D-conformal EBR and AD may reduce mortality in higher risk CLPC. RCTs in PSA-detected and MRI staged CLPC are needed.
Book Synopsis Therapies for Clinically Localized Prostate Cancer by : Fang Sun (M.D.)
Download or read book Therapies for Clinically Localized Prostate Cancer written by Fang Sun (M.D.) and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: To comprehensively update a 2008 systematic review on treatments for cancer confined to the prostate gland, which is the definition of clinically localized disease. DATA SOURCES: We searched MEDLINE(r), PreMEDLINE, Embase(r), the Cochrane Library, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment Database, gray literature, and the U.K. National Health Service Economic Evaluation Database for reports published from January 1, 2007, through March 7, 2014. REVIEW METHODS: We synthesized evidence from randomized controlled trials (RCTs) and nonrandomized comparative studies published in English that evaluated treatments and reported clinical or biochemical outcomes in patients with clinically localized prostate cancer. RESULTS: Eight RCTs and 44 nonrandomized comparative studies evaluating numerous treatment options met inclusion criteria. However, because most comparisons were represented by only one or two studies, the strength of evidence (SOE) was insufficient for the majority of comparisons. Two RCTs, the Scandinavian Prostate Cancer Group-4 (SPCG-4) and the Prostate Intervention Versus Observation Trial (PIVOT) compared radical prostatectomy (RP) and watchful waiting (WW) in localized prostate cancer patients. No meta-analysis was done because of the heterogeneity of included patients. While the SPCG-4 study found that RP reduced prostate cancer-specific mortality at 12 and 15 years, the PIVOT trial found no statistically significant difference at 12 years. The SPCG-4 study found that RP reduced all-cause mortality at 15 years, but neither the SPCG-4 nor the PIVOT trial found any significant difference at 12 years. The SOE for these outcomes was insufficient. However, both trials found significant reductions in progression to metastases in the RP group compared with the WW group (SOE: moderate). In the SPCG-4 trial, subgroup analyses showed reduced all-cause mortality among patients younger than 65 years and among patients with low tumor risk. In the PIVOT, reduced all-cause mortality was identified among men with prostate-specific antigen >10 ng/mL and among men with intermediate tumor risk. One RCT that compared three-dimensional conformal radiotherapy (3D-CRT) with 3D-CRT plus androgen-deprivation therapy (ADT) reported an improvement in overall survival and prostate cancer-specific mortality among men who received combined therapy (SOE: low). Six nonrandomized comparison studies reported that all-cause and prostate cancer-specific mortality was lower in patients treated with RP than in patients treated with external beam radiation therapy (SOE: low). The definition and severity of adverse events varied greatly across studies. Adverse events such as urinary incontinence and erectile dysfunction were reported mostly among men who underwent RP. Additionally, adverse events such as genitourinary toxicity, gastrointestinal toxicity, and erectile dysfunction were reported among men who received radiation therapy. CONCLUSIONS: This systematic review update found that the evidence for most treatment comparisons is largely inadequate to determine comparative risks and benefits of therapies for clinically localized prostate cancer. This conclusion is similar to that of the 2008 review, which found that no single therapy can be considered the preferred treatment for localized prostate cancer because of limitations in the body of evidence as well as the likely tradeoffs a patient must make between estimated treatment effectiveness, necessity, and adverse effects. Although limited evidence appears to favor surgery over WW or external beam radiotherapy, or favors 3D-CRT plus ADT over 3D-CRT alone, the patients most likely to benefit and the applicability of these study findings to contemporary patients and practice remain uncertain. More RCTs and better designed observational studies that can control for many of the known and unknown confounding factors that can affect long-term outcomes are needed to evaluate comparative risks and benefits of therapies for clinically localized prostate cancer.
Book Synopsis Focal Therapy in Prostate Cancer by : Hashim Uddin Ahmed
Download or read book Focal Therapy in Prostate Cancer written by Hashim Uddin Ahmed and published by John Wiley & Sons. This book was released on 2011-12-27 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book comprehensively reviews the potential of focal therapy and discusses why the changing face of prostate cancer warrants a change in the way we treat men with the disease. It deals with the mechanisms by which disease can be localized within the gland and then the different technologies used for focal ablation. Bringing together eminent contributors in one accessible reference, this book introduces focal therapy to all urologists, oncologists, and radiologists who are involved in the treatment of men with prostate cancer.
Author :Agency for Health Care Research and Quality (U.S.) Publisher :Government Printing Office ISBN 13 :1587634236 Total Pages :204 pages Book Rating :4.5/5 (876 download)
Book Synopsis Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide by : Agency for Health Care Research and Quality (U.S.)
Download or read book Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide written by Agency for Health Care Research and Quality (U.S.) and published by Government Printing Office. This book was released on 2013-02-21 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)
Book Synopsis Clinical Oncology by : Martin D. Abeloff
Download or read book Clinical Oncology written by Martin D. Abeloff and published by . This book was released on 2000 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A must-have reference, this new edition provides practical information on treatment guidelines, details of diagnosis and therapy, and personal recommendations on patient management from experts in the field. Consistently formatted chapters allow for a user-friendly presentation for quick access of key information by the practicing clinician. Completely updated, this new edition includes all of the latest developments in treatment strategies of medical, surgical and radiation oncologists.
Book Synopsis Adenocarcinoma of the Prostate by : Andrew W. Bruce
Download or read book Adenocarcinoma of the Prostate written by Andrew W. Bruce and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 363 pages. Available in PDF, EPUB and Kindle. Book excerpt: Carcinoma of the prostate increasingly dominates the attention of urologists for both scientific and clinical reasons. The search for an explanation and the prediction of the variable behaviour of the malignant prostatic cell continues unabated. The search for more precise tumour staging and more effective treatment is equally vigorous. Editors Andrew Bruce and John Trachtenberg have assembled acknowledged leaders in prostate cancer to present those areas of direct interest to the clinician. There are a number of other topics that might have been considered but most of these, such as experimental tumour models or biochemical factors affecting cell growth, still lack immediate application for the clinician. Carcinoma of the prostate continues to have its highest incidence in the western world, and the difference in comparison with the incidence in the Far East appears to be real and not masked by diagnostic or other factors. A number of other epidemiological aspects need careful analysis: Is the incidence increasing? Is the survival improving? Is the prognosis worse in the younger patient? Epidemiological data are easily misused and misinterpreted so that a precise analysis of the known facts makes an important opening chapter to this book.
Book Synopsis Evidence-based Urology by : Philipp Dahm
Download or read book Evidence-based Urology written by Philipp Dahm and published by John Wiley & Sons. This book was released on 2018-09-24 with total page 614 pages. Available in PDF, EPUB and Kindle. Book excerpt: An updated and revised resource to evidence-based urology information and a guide for clinical practice The revised and updated second edition of Evidence-Based Urology offers the most current information on the suitability of both medical and surgical treatment options for a broad spectrum of urological conditions based on the best evidence available. The text covers each of the main urologic areas in specific sections such as general urology, oncology, female urology, trauma/reconstruction, pediatric urology, etc. All the evidence presented is rated for quality using the respected GRADE framework. Throughout the text, the authors highlight the most patient-important, clinical questions likely to be encountered by urologists in day-to-day practice. A key title in the “Evidence-Based” series, this revised and expanded edition of Evidence-Based Urology contains new chapters on a variety of topics including: quality improvement, seminoma, nonseminomatous germ cell tumor, penile cancer, medical prophylaxis, vesicoureteral reflux disease, cryptorchidism, prenatal hydronephrosis, and myelodysplasia. This updated resource: Offers a guide that centers on 100% evidence approach to medical and surgical approaches Provides practical recommendations for the care of individual patients Includes nine new chapters on the most recently trending topics Contains information for effective patient management regimes that are supported by evidence Puts the focus on the most important patient and clinical questions that are commonly encountered in day-to-day practice Written for urologists of all levels of practice, Evidence-Based Urology offers an invaluable treasure-trove of evidence-based information that is distilled into guidance for clinical practice.
Book Synopsis 50 Studies Every Urologist Should Know by : Philipp Dahm
Download or read book 50 Studies Every Urologist Should Know written by Philipp Dahm and published by Oxford University Press. This book was released on 2021-02-26 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt: 50 Studies Every Urologist Should Know presents key studies that have shaped the practice of urology. Selected using a rigorous methodology, the studies cover topics including reflux disease in paediatric urology, management of male erectile dysfunction and lower urinary tract symptoms, female urology and stone disease, the various forms of genitourinary cancer, and more. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for healthcare professionals in urology, as well as anyone who wants to learn more about the data behind clinical practice.
Book Synopsis Stereotactic Body Radiation Therapy by : Simon S. Lo
Download or read book Stereotactic Body Radiation Therapy written by Simon S. Lo and published by Springer Science & Business Media. This book was released on 2012-08-28 with total page 433 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.
Book Synopsis Initial National Priorities for Comparative Effectiveness Research by : Institute of Medicine
Download or read book Initial National Priorities for Comparative Effectiveness Research written by Institute of Medicine and published by National Academies Press. This book was released on 2009-11-14 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise. As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.
Book Synopsis Finding What Works in Health Care by : Institute of Medicine
Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
Book Synopsis Image-Guided IMRT by : Thomas Bortfeld
Download or read book Image-Guided IMRT written by Thomas Bortfeld and published by Springer Science & Business Media. This book was released on 2006-05-28 with total page 452 pages. Available in PDF, EPUB and Kindle. Book excerpt: Intensity-modulated radiation therapy (IMRT), one of the most important developments in radiation oncology in the past 25 years, involves technology to deliver radiation to tumors in the right location, quantity and time. Unavoidable irradiation of surrounding normal tissues is distributed so as to preserve their function. The achievements and future directions in the field are grouped in the three sections of the book, each suitable for supporting a teaching course. Part 1 contains topical reviews of the basic principles of IMRT, part 2 describes advanced techniques such as image-guided and biologically based approaches, and part 3 focuses on investigation of IMRT to improve outcome at various cancer sites.
