A public health intervention program to improve the initial management of soft tissue sarcomas

Abstract

17546 Background: A quasi-experimental before/after study funded by a National Grant, has been implemented to set up and evaluate a public health intervention designed to improve the quality of the initial management of Soft Tissue Sarcomas (STS), in collaboration with the French Sarcoma Group (FSG), regional cancer registries and cancer regional networks. As a preliminary step, we have validated quality indicators (QIs) for cancer care, i.e., we have assessed which QIs are the most relevant to evaluate the quality of the management of STS. Methods: This two-year study involves five regions (covering 20% of the French population); 300 STS cases per year will be recruited. The public health program is implemented in four regions (the fifth region serves as a control), and the interventions are the following ones: 1) information written campaign directed towards all relevant practitioners, 2) oral communications in dedicated meetings by opinion leaders, 3) systematic written information to the surgeons whenever an STS is histological proven. To validate QIs, a consensus Delphi method was set up. Based on Good Clinical Practices and a literature review, we prepared a set of 25 QIs, and relied on a panel of advisory FSG experts (n = 19) involving multiple medical specialties. Results: Data specific to the implementation of the public health program are currently being collected. Preliminary data suggest an increased number of reported STS cases compared to the initial estimation which was based on a national estimation. For example, 46 cases were recruited over 6 months in one region (3 millions inhabitants), instead of the expected 30 cases (50% increase). With respect to the QIs, response rates were excellent (95%); consensus was reached for 18 items, with perfect consensus for 9 QIs (e.g., the need for multidisciplinary management teams, appropriate surgical biopsy techniques). Conclusions: Our analysis confirms the presence of a consensus among French STS experts. The relevant QIs will be used to evaluate the public health intervention which will allow us to 1) obtain a picture of the current practices in the management of STS patients; 2) assess if simple actions can improve practices; 3) estimate the STS incidence in 5 regions. No significant financial relationships to disclose.