EAN: 9783319125527

COMPARATIVE EFFECTIVENESS IN SURGICAL ONCOLOGY ...

Despite tremendous recent advances in the treatment of most malignancies  there remain several
critical questions for each cancer. This particularly true for the surgical management of
solid-organ malignancies. Comparative effectiveness is a relatively new term which encompasses
the age-old concepts of how best to treat cancer patients. Comparative effectiveness is defined
as the direct comparison of healthcare interventions to determine which work best for which
patients when considering the benefits and risks. The Institute of Medicine has defined
comparative effectiveness research (CER) as the generation and synthesis of evidence that
compares the benefits and harms of alternative methods to prevent  diagnose  treat  and monitor
a clinical condition or to improve the delivery of care. CER is certainly best done with
well-conducted randomized controlled trials. Unfortunately  clinical trials are not always
feasible owing to the impracticality of conducting the trial  the considerable cost  and the
time required to complete the trial. These challenges are even more pronounced with respect to
surgical treatment. Thus alternative approaches may need to be considered in order to address
pressing questions in the care of the oncology patient. These approaches may include
well-conducted retrospective cohort studies from cancer registries and other data sources 
decision and cost-effectiveness analyses  and other novel methodologies. This book lays out the
current critical questions for each major malignancy and proposes approaches to gain answers to
these pressing questions.

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