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      Medical Care and Survival of Soft-Tissue and Bone Sarcoma Patients: Results and Methodological Aspects of a German Subnational Cohort Study Based on Administrative Healthcare Data

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          Abstract

          Introduction: Medical care of soft-tissue sarcoma (STS) and bone sarcoma (BS) patients in Germany has rarely been investigated. The objectives of this article were (1) to investigate medical care and survival in STS and BS patients, and (2) to examine methodological aspects of corresponding analyses based on administrative healthcare data. Methods: We analyzed data from a statutory health insurance located in Saxony, Germany, covering approximately 2 million individuals. We identified incident STS and BS patients in the period 2012–2016 using 4 different case definitions. We examined treatment rates and visits to medical oncologists and medical practices descriptively, and then compared results between case definitions. We investigated survival prospects using a relative survival analysis and estimated hazard ratios (HRs) for risk factors for mortality using Cox regression. Results: Across case definitions, the number of included sarcoma patients (STS: n = 871–1,757; BS: n = 216–689) and applied treatments (STS: 42.2–83.1%; BS: 28.3–77.8%) varied substantially. Irrespective of the case definition, the minority of patients visited medical oncologists (STS: 9.8–10.8% BS: 4.4–7.9%) and “experienced” medical practices (STS: 27.7–38.4%; BS: 18.3–23.6%). Survival prospects were better for patients who visited “experienced” medical practices (STS: HR = 0.55; BS: HR = 0.42). Conclusion: Treatment rates clearly <100% and evidence from survival analyses indicate the potential for improvements in the care of sarcoma patients in Germany, e.g., by physicians in “experienced” medical practices.

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          Most cited references 12

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          [Good Practice of Secondary Data Analysis (GPS): guidelines and recommendations].

           E Swart,  H. Gothe,  S Geyer (2015)
          In 2005, the Working Group for the Survey and Utilisation of Secondary Data (AGENS) of the German Society for Social Medicine and Prevention (DGSMP) and the German Society for Epidemiology (DGEpi) first published "Good Practice in Secondary Data Analysis (GPS)" formulating a standard for conducting secondary data analyses. GPS is intended as a guide for planning and conducting analyses and can provide a basis for contracts between data owners. The domain of these guidelines does not only include data routinely gathered by statutory health insurance funds and further statutory social insurance funds, but all forms of secondary data. The 11 guidelines range from ethical principles and study planning through quality assurance measures and data preparation to data privacy, contractual conditions and responsible communication of analytical results. They are complemented by explanations and practical assistance in the form of recommendations. GPS targets all persons directing their attention to secondary data, their analysis and interpretation from a scientific point of view and by employing scientific methods. This includes data owners. Furthermore, GPS is suitable to assess scientific publications regarding their quality by authors, referees and readers. In 2008, the first version of GPS was evaluated and revised by members of AGENS and the Epidemiological Methods Working Group of DGEpi, DGSMP and GMDS including other epidemiological experts and had then been accredited as implementation regulations of Good Epidemiological Practice (GEP). Since 2012, this third version of GPS is on hand and available for downloading from the DGEpi website at no charge. Especially linguistic specifications have been integrated into the current revision; its internal consistency was increased. With regards to contents, further recommendations concerning the guideline on data privacy have been added. On the basis of future developments in science and data privacy, further revisions will follow.
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            The multidisciplinary management of bone and soft tissue sarcoma: an essential organizational framework

            The rarity of bone and soft tissue sarcoma, the difficulty in interpretation of imaging and histology, the plethora of treatment modalities, and the complexity and intensity of the treatment contribute to the need for systematic multidisciplinary team management of patients with these diseases. An integrated multidisciplinary clinic and team with a structured sarcoma tumor board facilitate team coordination and communication. This paper reviews the rationale for multidisciplinary management of sarcoma and details the operational structure of the Multidisciplinary Sarcoma Clinic and Sarcoma Tumor Board. The structured Multidisciplinary Sarcoma Tumor Board provides opportunity for improvement in logistics, teaching, quality, and enrollment in clinical trials.
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              Health service use among patients with chronic or multiple illnesses, and frequent attenders: secondary analysis of routine primary care data from 1996 to 2006.

              Little or no longitudinal data have been available to date on the utilization of primary care physicians' services, particularly by chronically ill and multimorbid patients and by those who see their primary care physician often ("frequent attenders").
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                Author and article information

                Journal
                ORT
                Oncol Res Treat
                10.1159/issn.2296-5270
                Oncology Research and Treatment
                S. Karger AG
                2296-5270
                2296-5262
                2021
                March 2021
                30 December 2020
                : 44
                : 3
                : 103-110
                Affiliations
                aZentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Dresden, Germany
                bAbteilung für Tumororthopädie und Sarkomchirurgie, Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, Bad Saarow, Germany
                cKlinik für Allgemein-, Viszeral- und Kinderchirurgie, Georg-August-Universität, Universitätsmedizin Göttingen, Göttingen, Germany
                dNationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany
                eMedizinische Klinik I, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany
                fKlinik für Onkologie, HELIOS Klinikum Emil von Behring, Berlin, Germany
                Author notes
                *Martin Roessler, Zentrum für evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Fetscherstrasse 74, DE–01307 Dresden (Germany), martin.roessler@uniklinikum-dresden.de
                Article
                513178 Oncol Res Treat 2021;44:103–110
                10.1159/000513178
                33378758
                © 2020 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 2, Pages: 8
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/513178
                Categories
                Research Article

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