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    Brachytherapy. 2020 Sep 22. pii: S1538-4721(20)30186-0. doi: 10.1016/j.brachy.2020.08.011
    Initiatives for education, training, and dissemination of morbidity assessment and reporting in a multiinstitutional international context: Insights from the EMBRACE studies on cervical cancer.
    Kirchheiner K1,  Smet S2,  Spampinato S3,  Jensen NBK4,  Vittrup AS5,  Fokdal L6,  Najjari-Jamal D7,  Westerveld HG8,  Lindegaard JC9,  Kirisits C10,  De Leeuw A11,  Schmid MP12,  Tan LT13,  Nout RA14,  Jürgenliemk-Schulz IM15,  Pötter R16,  Tanderup K17
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    Abstract

    In 2008, the GEC ESTRO Gyn network launched the first multiinstitutional, observational, and prospective international study on MRI-guided brachytherapy in locally advanced cervical cancer patients (EMBRACE-I). EMBRACE-I was followed by EMBRACE-II from 2016 and ongoing. Among the aims of the EMBRACE studies are to benchmark morbidity outcomes and develop dose-volume effects and predictive models for morbidity. The EMBRACE studies collect both physician (CTCAE v.3) and patient (EORTC QLQ-C30/CX24) reported outcomes, including baseline information, in a regular follow-up schedule. The EMBRACE studies feature high numbers of patients (EMBRACE-I N = 1416, EMBRACE-II N = 1500 expected) enrolled from many institutions worldwide (EMBRACE-I n = 23, EMBRACE-II n = 45). This large-scale multiinstitutional approach offers a unique opportunity to investigate and develop new strategies for improving the quality of assessment and reporting of morbidity. This report presents an overview of the challenges and pitfalls regarding the assessment and reporting of morbidity encountered during more than a decade of development and research activities within the EMBRACE consortium. This includes the recognition and evaluation of inconsistencies in the morbidity assessment, and consequently, the provision of assistance and training in the scoring procedure to reduce systematic assessment bias. In parallel, a variety of methodological approaches were tested to comprehensively summarize morbidity outcomes, and a novel approach was developed to refine dose-effect models and risk factor analyses. The purpose of this report is to present an overview of these findings, describe the learning process, and the strategies that have consequently been implemented regarding educational activities, training, and dissemination.


    Copyright © 2020 American Brachytherapy Society. All rights reserved.

    KEYWORDS: Education/dissemination, Locally advanced cervical cancer, MRI-Guided adaptive brachytherapy, Morbidity assessment, Morbidity reporting, Radiochemotherapy

    Publikations ID: 32978080
    Quelle: öffnen
     
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