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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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          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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          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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                Author and article information

                Oncol Res Treat
                Oncology Research and Treatment
                S. Karger AG
                March 2021
                30 December 2020
                : 44
                : 3
                : 103-110
                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
                513178 Oncol Res Treat 2021;44:103–110
                © 2020 S. Karger AG, Basel

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


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