Difficult clinical decisions in gynecological oncology: identifying priorities for future clinical research. 2006

J D Harrison, and J Carter, and J M Young, and M J Solomon
Surgical Outcomes Research Centre, Sydney South West Area Health Service and the University of Sydney, Missenden Road, NSW 2050, Sydney, Australia. james.harrison@email.nsw.gov.au

This study investigates the acceptability and feasibility of conducting randomized controlled trials (RCTs) in gynecological oncology by ascertaining the views of the Australian Society of Gynaecologic Oncologists (ASGO) about important clinical questions in this field, current treatment preferences, and willingness to participate in trials to address these questions. Members of ASGO received a mailed survey. Thirty-one gyneoncologists participated in this study (79% response fraction). There was considerable support for an RCT (81%; 95% confidence interval [CI], 63-93%) to compare sentinel node biopsy with total groin dissection for women with vulval cancer. This clinical question was also rated as "extremely" or "very" important by 91% (95% CI, 74-98%) of respondents, who also indicated high levels of individual equipoise. Another priority for research involved the use of second-line chemotherapy for women who have rising CA125 titers. This clinical question was rated as extremely or very important by 71% (95% CI, 52-86%), exhibited high levels of individual equipoise, with 74% (95% CI, 55-88%) of respondents willing to participate in an RCT to address this issue. The conduct of surveys of representative groups of clinicians provides useful empirical data to focus clinical research efforts where they are most likely to be successful based on equipoise, feasibility, and clinical interest.

UI MeSH Term Description Entries
D008297 Male Males
D008495 Medical Oncology A subspecialty of internal medicine concerned with the study of neoplasms. Oncology, Medical,Clinical Oncology,Oncology, Clinical
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010818 Practice Patterns, Physicians' Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided. Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D011787 Quality of Health Care The levels of excellence which characterize the health service or health care provided based on accepted standards of quality. Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D012107 Research Design A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. Experimental Design,Data Adjustment,Data Reporting,Design, Experimental,Designs, Experimental,Error Sources,Experimental Designs,Matched Groups,Methodology, Research,Problem Formulation,Research Methodology,Research Proposal,Research Strategy,Research Technics,Research Techniques,Scoring Methods,Adjustment, Data,Adjustments, Data,Data Adjustments,Design, Research,Designs, Research,Error Source,Formulation, Problem,Formulations, Problem,Group, Matched,Groups, Matched,Matched Group,Method, Scoring,Methods, Scoring,Problem Formulations,Proposal, Research,Proposals, Research,Reporting, Data,Research Designs,Research Proposals,Research Strategies,Research Technic,Research Technique,Scoring Method,Source, Error,Sources, Error,Strategies, Research,Strategy, Research,Technic, Research,Technics, Research,Technique, Research,Techniques, Research
D003657 Decision Making The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D005260 Female Females
D005544 Forecasting The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology. Futurology,Projections and Predictions,Future,Predictions and Projections

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