Navigation Links
In Germany, children with cancer have a high probability of survival
Date:11/24/2009

This release is available in German.

Internationally viewed, medical care in Germany for children with cancer is very good as far as survival is concerned. However, other aspects, such as quality of life, pain, and long-term consequences of the disease are still insufficiently investigated in studies. This is the conclusion of the Institute for Quality and Efficiency in Health Care (IQWiG) in its final report published on 16 October 2009.

Establish mandatory quality standards

Every year in Germany approximately 1800 children under 15 years of age are diagnosed with cancer. In order to provide them with the best possible care, the Federal Joint Committee (G-BA) drew up a quality assurance agreement in 2007 (Quality Assurance Agreement on Paediatric Oncology). Its aim is to ensure that hospitals in Germany follow mandatory standards in providing care to children and adolescents with cancer.

In order to ensure quality of care in the long term, the G-BA also commissioned IQWiG to present a scientific evaluation of both the current status of the existing infrastructure und the quality of care prior to the agreement. The Committee wishes to establish whether and how the already existing quality requirements need to be adapted.

Analysis of medical care difficult

The aim of the medical care analysis commissioned by the G-BA is not only to describe the current status of quality of care, but also to undertake an international comparison and identify any potential areas for improvement. As medical care in the field of oncology is very complex, CPGs, narrative overviews, and official statistics were also included alongside a total of 106 therapy-optimizing, cohort and cross-sectional studies. This distinguishes this analysis from the Institute's benefit assessments of medical procedures.

From the very beginning of the investigation it was clear that reliable quality indicators for procedures and infrastructure are lacking in paediatric oncology in Germany. Cross-sectional studies were therefore identified that described at least some features of infrastructure. This includes, for example, facilities in the largest hospitals, palliative care, and the situation regarding psychosocial services. However, there was no information on smaller hospitals and their infrastructure.

80% of children survive at least 5 years

IQWiG restricted the investigation to the most common oncological diseases. Children and adolescents who had acute lymphoblast leukaemia (ALL) or acute myeloid leukaemia (AML), non-Hodgkin lymphomas (NHL), Hodgkin's disease or tumours in the central nervous system (CNS) were included.

IQWiG came to the conclusion that overall more than 80% of children with cancer in Germany between 2000 and 2004 survived at least 5 years. 90% of children with cancer received treatment here in Germany in therapy-optimizing studies, which is also an indicator of a high standard of care. When survival probability is compared internationally, medical care in paediatric oncology is very good in Germany. Over the last 20 to 30 years it has improved markedly.

During the "submission of comments" procedure, references to additional publications were given by the professional association, which could then be incorporated into the final report. Thus, IQWiG was able to additionally assess the "event-free survival" outcome of children diagnosed with high-grade brain tumours.

Lack of studies on important outcomes

However, on other important patient-relevant outcomes, such as "health-related quality of life" and "pain", there was a paucity of studies. For the "deaths due to therapy" outcome, studies on AML and ALL as well as NHL could be located, but there are no clinical comparisons for Hodgkin's disease and CNS tumours.

There is also a lack of studies that systematically investigate "long-term consequences" of disease and therapy, although this does not apply to second tumours. The German Childhood Cancer Registry records not only all primary tumours but second tumours as well. Children and adolescents who have survived cancer are 10 to 20 times more likely to develop a tumour again than the general population. A similarly high risk is also reported in international studies.

Infrastructure: lack of quality indicators

Part of IQWiG's commission was also concerned with examining the existing quality of procedures and infrastructure. Up till now, however, there have been no defined quality indicators in paediatrics or paediatric haemato-oncology in Germany.

IQWiG did find indications of some aspects of infrastructure, such as a parent staying with their child in hospital or the value of music therapy in the management of the disease (often based on narrative overviews). However, the Institute cannot draw a general conclusion concerning specific aspects of infrastructure, as there are only a few studies. The results often refer exclusively to the large centres or are partially out of date.

More studies are necessary as well as a discussion on quality

Further studies are urgently needed. This particularly refers to the following patient-relevant outcomes that up till now have been neglected in studies: "quality of life", "pain", and "long-term consequences". Only then can it be determined whether the evidence gaps are actually concealing deficits in care.

It is also vital to continue the discussion on indicators that can measure quality of infrastructure and procedures. Uniform indicators must be applied across Germany if the success of quality assurance measures used to date are to be evaluated.


'/>"/>

Contact: Dr. Anna-Sabine Ernst
info@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

Related medicine news :

1. Children who lack continuity with a regular health care provider miss needed services
2. Exposures to metals and diesel emissions in air linked to respiratory symptoms in children
3. Reportlinker Adds Childrens Food and Drinks in Europe - A Guide to Markets, Products and Innovation 2nd Edition
4. Ann Taylor Stores Corp. Returns To St. Jude Childrens Research Hospitals Thanks and Giving Campaign(R) For The Third Year
5. Amid the flu epidemic, dont forget RSV in young children
6. Amid the Flu Epidemic, Dont Forget RSV in Young Children
7. Daycare may double TV time for young children, study finds
8. High blood pressure easy to miss in children with kidney disease
9. DKNY JEANS Launches Exclusive Collection With HSN for St. Jude Childrens Research Hospitals Thanks and Giving(R) Campaign
10. CVS/pharmacy Kicks Off Annual Thanks and Giving(R) Campaign for the St. Jude Childrens Research Hospital
11. Immunology expert at Childrens Hospital receives APS prize for patient-oriented research
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... Falls, NY & Salt Lake City, UT (PRWEB) , ... February ... ... Davis, Founder of Activz Whole-Food Nutrition , announced that the much-anticipated feature with ... on the New Really Cool Humans Amateur TV Network. , Each week, on his ...
(Date:2/5/2016)... York, New York (PRWEB) , ... February 05, 2016 , ... ... life? The answer may be at the tips of your toes. Foot massage, whether ... as well as pure comfort and relaxation. The American Board of Multiple Specialties ...
(Date:2/5/2016)... Chicago, Illinois (PRWEB) , ... February 05, 2016 ... ... advisors and independent PROSHRED franchises from across the country gathered at the La ... to recognize top performers. PROSHRED Chicago was named the year’s most outstanding ...
(Date:2/5/2016)... ... February 05, 2016 , ... Pivot Point ... Best in KLAS: Software & Services for HIT Implementation Support & Staffing report ... independently ranks vendor performance by healthcare executives, managers and clinicians representing over 4,500 ...
(Date:2/5/2016)... Viejo, CA (PRWEB) , ... February 05, 2016 , ... ... X. Move from on one drop zone to the next using Colorize's dynamic moving ... complements any project. This package includes a 3D slideshow environment with 1 to 5 ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... , Feb. 5, 2016 ... the addition of the "Global Musculoskeletal ... company profile to their offering. ... the addition of the "Global Musculoskeletal ... company profile to their offering. ...
(Date:2/5/2016)... New York , February 5, 2016 ... new Transparency Market Research report states that the global ... in 2014 and is predicted to reach US$185.9 bn ... CAGR of 6.50% from 2014 to 2020. The title ... (Branded/Generic/Over-the-counter, Chemical/Biological, Captive/Contract Manufactured, by Geography, and by Therapeutic ...
(Date:2/5/2016)... , February 5, 2016 ... new market research report "Fetal (Labor & Delivery) and ... Antepartum), Warmer, Incubator, Pulse Oximeter, Phototherapy/Jaundice Management Devices, CPAP, ... by MarketsandMarkets, This report studies the global market over ... is estimated at USD 6.28 Billion in 2015 and ...
Breaking Medicine Technology: