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Choosing wisely in oncology: necessity and obstacles
In the last decades, the survival of many patients with cancer improved thanks to modern diagnostic methods and progresses in therapy. Still for several tumours, especially when diagnosed at an advanced stage, the benefits of treatment in terms of increased survival or quality of life are at best mo...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045771/ https://www.ncbi.nlm.nih.gov/pubmed/30018817 http://dx.doi.org/10.1136/esmoopen-2018-000382 |
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author | Saletti, Piercarlo Sanna, Piero Gabutti, Luca Ghielmini, Michele |
author_facet | Saletti, Piercarlo Sanna, Piero Gabutti, Luca Ghielmini, Michele |
author_sort | Saletti, Piercarlo |
collection | PubMed |
description | In the last decades, the survival of many patients with cancer improved thanks to modern diagnostic methods and progresses in therapy. Still for several tumours, especially when diagnosed at an advanced stage, the benefits of treatment in terms of increased survival or quality of life are at best modest when not marginal, and should be weighed against the potential discomfort caused by medical procedures. As in other specialties, in oncology as well the dialogue between doctor and patient should be encouraged about the potential overuse of diagnostic procedures or treatments. Several oncological societies produced recommendations similar to those proposed by other medical disciplines adhering to the Choosing Wisely (CW) campaign. In this review, we describe what was reported in the medical literature concerning adequacy of screening, diagnostic, treatment and follow-up procedures and the potential impact on them of the CW. We only marginally touch on the more complex topic of treatment appropriateness, for which several evaluation methods have been developed (including the European Society for Medical Oncology—magnitude of clinical benefit scale). Finally, we review the possible obstacles for the development of CW in the oncological setting and focus on the strategies which could allow CW to evolve in the cancer field, so as to enhance the therapeutic relationship between medical professionals and patients and promote more appropriate management. |
format | Online Article Text |
id | pubmed-6045771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-60457712018-07-17 Choosing wisely in oncology: necessity and obstacles Saletti, Piercarlo Sanna, Piero Gabutti, Luca Ghielmini, Michele ESMO Open Review In the last decades, the survival of many patients with cancer improved thanks to modern diagnostic methods and progresses in therapy. Still for several tumours, especially when diagnosed at an advanced stage, the benefits of treatment in terms of increased survival or quality of life are at best modest when not marginal, and should be weighed against the potential discomfort caused by medical procedures. As in other specialties, in oncology as well the dialogue between doctor and patient should be encouraged about the potential overuse of diagnostic procedures or treatments. Several oncological societies produced recommendations similar to those proposed by other medical disciplines adhering to the Choosing Wisely (CW) campaign. In this review, we describe what was reported in the medical literature concerning adequacy of screening, diagnostic, treatment and follow-up procedures and the potential impact on them of the CW. We only marginally touch on the more complex topic of treatment appropriateness, for which several evaluation methods have been developed (including the European Society for Medical Oncology—magnitude of clinical benefit scale). Finally, we review the possible obstacles for the development of CW in the oncological setting and focus on the strategies which could allow CW to evolve in the cancer field, so as to enhance the therapeutic relationship between medical professionals and patients and promote more appropriate management. BMJ Publishing Group 2018-07-11 /pmc/articles/PMC6045771/ /pubmed/30018817 http://dx.doi.org/10.1136/esmoopen-2018-000382 Text en © European Society for Medical Oncology 2018. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Review Saletti, Piercarlo Sanna, Piero Gabutti, Luca Ghielmini, Michele Choosing wisely in oncology: necessity and obstacles |
title | Choosing wisely in oncology: necessity and obstacles |
title_full | Choosing wisely in oncology: necessity and obstacles |
title_fullStr | Choosing wisely in oncology: necessity and obstacles |
title_full_unstemmed | Choosing wisely in oncology: necessity and obstacles |
title_short | Choosing wisely in oncology: necessity and obstacles |
title_sort | choosing wisely in oncology: necessity and obstacles |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045771/ https://www.ncbi.nlm.nih.gov/pubmed/30018817 http://dx.doi.org/10.1136/esmoopen-2018-000382 |
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