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Benefits Of Timely Care In Pancreatic Cancer: A Systematic Review To Navigate Through The Contradictory Evidence

Authors Lukács G, Kovács Á, Csanádi M, Moizs M, Repa I, Kaló Z, Vokó Z, Pitter JG

Received 1 July 2019

Accepted for publication 15 October 2019

Published 19 November 2019 Volume 2019:11 Pages 9849—9861

DOI https://doi.org/10.2147/CMAR.S221427

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Gábor Lukács,1,2 Árpád Kovács,1,2 Marcell Csanádi,3 Mariann Moizs,1 Imre Repa,1,2 Zoltán Kaló,3,4 Zoltán Vokó,3,4 János György Pitter3

1Móritz Kaposi General Hospital, Kaposvár, Hungary; 2Doctoral School, Faculty of Health Sciences, University of Pécs, Pécs, Hungary; 3Syreon Research Institute, Budapest, Hungary; 4Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary

Correspondence: János György Pitter
Syreon Research Institute, 65/A Mexikói Út, Budapest 1142, Hungary
Tel +36 20 454 7887
Fax +36 1 220 5768
Email janos.pitter@syreon.eu

Abstract: The evidence base of policies that improve the timeliness of cancer care is under ongoing debate. Pancreatic cancer is frequently diagnosed in a stage when curative therapy is not feasible; hence, it is an important target for timelier healthcare interventions. The objectives of our research were to identify all clinical studies on pancreatic cancer care delays via a systematic literature review, to assess the study methodologies for possible biases, to conclude on the available evidence, and to formulate research recommendations on evidence gaps. Nineteen studies were identified and eight reported multivariate analyses. Although many sources of bias shifted the results towards negative or paradoxical findings, a statistically significant association of shorter delays with better clinical outcomes was demonstrated in the majority of studies reporting multivariate analyses. Noninferiority analyses were not published. Further efforts to provide timely care for pancreatic cancer patients are encouraged, and studies on the associations of delay with patient experience and healthcare resource utilization are warranted.

Keywords: pancreatic cancer, delay, wait time, prognosis, bias, systematic review

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