Re: Pediatric Oncologists
In the Navy, we get a decent amount of "Total Quality" training, and in a
course called Continuing Clinical Quality Improvement, they have a film
which features a pediatric oncologist explaining the profession's
long-standing involvement in "Quality Improvement" and quoted similar
numbers of kids involved in trials. He made it sound as if the profession
does a tremendous amount of self-evaluation (more than "usual"). I don't
know if the CQI came first and EBM was applied as a tool or vice-versa, but
I imagine it stems from 1) a desire to limit the dramatically tragic
outcomes with which pediatric oncology deals, but also 2) maybe because of
fund-raising and availability of research money - it seems that there are
lots of telethons and the like for pediatric cancer (just an impression, no
data).
Why not others? Maybe because of the opposite of the reasons above...?
After all, they did go to the same med schools as the rest of us...didn't
they?
john
John Epling, MD
LCDR, MC, USNR
Family Practice Residency Program
US Naval Hospital
2080 Child St.
Jacksonville, FL 32214
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> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of
> Michael Power
> Sent: Friday, October 23, 1998 9:26 AM
> To: [log in to unmask]
> Subject: paediatric oncology - paediatric oncology - lessons for EBM
>
>
> a colleague recently drew my attention to some interesting
> statistics: In the USA >70% of paediatric patients with cancer are
> entered into at least one clincal trial; only 2% of adults with
> cancer are entered into trials
>
> internationally (in the developed world at least) most children with
> cancer are treated according to a defined protocol - And, systems
> exist to facilitate sharing experience.
>
> In the past 25 years survival times and side-effects from treatment
> have improved dramatically for children with cancer (eg from 40% to
> 70% cure rates) in contrast to minor improvements for adult with
> cancer even though there have been no new "frontline" therapeutic
> agents.
>
> it seems that paediatric oncologists have been doing EBM for a
> quarter of a century: putting evidence into practice and getting
> practice into evidence although they do not use the language of the
> EBM/H/P community.
>
> this raises 2 questions which (at the risk of exposing my ignorance)
> i should like to ask:
>
> 1) why haven't EBM-ers looked to see why the paediatric oncology
> community seem to have go it right?
>
> 2) why have other specialities not followed the example of the
> paediatric oncologists
>
> michael power
>
> some references:
>
> Bleyer WA. The US pediatric cancer clinical trials programmes:
> International implications and the way forward. European Journal of
> Cancer 1997; 33: 1439-1447
>
> Philip T. Lymphoblastic lymphoma and Burkitt's lymphoma in Caucasian
> adults: Please don't forget the pediatric experience. Annals of
> Oncology 1995; 6: 414-416
>
> Simone JV, Lyons J. The evolution of cancer care for children and
> adults. Journal of Clincal Oncology 1998; 16: 2904-2905
>
>
> ----------------------------------------------------------------------
> Dr Michael Power, Department of Paediatrics and Child Health,
> University of Cape Town & Red Cross Children's Hospital,
> Rondebosch 7700, Cape Town, South Africa
> Tel (27 21) 658 5111 Fax (27 21) 689 1287
> email [log in to unmask]
>
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