Perceived impact on clinical practice and logistical issues in clinical management surveys of cancer: Australian experience

Abstract

Background: In September 2004, 28 published and 17 ongoing clinical management surveys (CMS) of cancer in Australia were identified, describing the clinical management of representative series of cancer patients. The present study assessed the perceived influence of these on clinical practice and the logistical issues involved in conducting a CMS.

Methods and materials: Questionnaire sent to a key clinical investigator in each survey.

Results: For the 28 published CMS, respondents (response rate 54%) reported that the CMS were influential in half or more of subsequent changes in the development or implementation of standard protocols, increasing specialist involvement in clinical trials, reducing variability in practice, and providing informed choice for patients. The surveys were regarded as influential in a third to half of noted changes in the use of evidence-based treatments, multidisciplinary care, and standardised collection of data. For CMS in progress, respondents (response rate 65%) reported on objectives and logistical issues, with the need for multiple ethical approvals emerging as a major issue.

Conclusion: CMS of cancer have played a modest but important role in stimulating and supporting improvements in clinical care in Australia. Many Australian surveys have been large and population-based and with high response rates. The recent introduction of a requirement for patient consent by some (but not all) ethical committees greatly increases the difficulties and costs of such surveys.