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Related Experiment Videos

Growth factor usage patterns and outcomes in the community setting: collection through a practice-based computerized

G Swanson1, K Bergstrom, E Stump

  • 1OnCare Inc, Atlanta, GA, USA.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|April 14, 2000
PubMed
Summary

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Medical oncologists show wide variation in colony-stimulating factor (CSF) use, deviating from guidelines. Computerized systems reveal practice patterns differ from surveys, highlighting the need for more research on G-CSF versus GM-CSF.

Area of Science:

  • Oncology
  • Hematology
  • Clinical Practice Research

Background:

  • Colony-stimulating factors (CSFs) are widely used in cancer treatment.
  • Existing guidelines for CSF use have been disseminated to medical oncologists.
  • Actual practice patterns of medical oncologists regarding CSF use remain largely unknown.

Purpose of the Study:

  • To collect data on the actual practice patterns of medical oncologists concerning CSF use.
  • To utilize an office-based computerized clinical information system for data collection.
  • To compare actual practice patterns with reported behaviors and guidelines.

Main Methods:

  • Data collected retrospectively from 10 community-based oncology practices.
  • CSF use captured at the time of prescribing via a computerized clinical support tool.

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  • Analysis of 6,813 cancer regimens administered to 5,034 patients.

    • Main Results:

    • CSFs were used in 14% of cancer regimens, most commonly in breast, lymphoma, lung, and ovarian cancers.
    • CSF initiation often occurred in cycle 1 (49.4%), with an average duration of 1 week over two or three cycles.
    • Granulocyte colony-stimulating factor (G-CSF) showed associations with fewer adverse events (dose adjustments, delays, hospitalizations) compared to granulocyte-macrophage colony stimulating factor (GM-CSF).
    • Significant variation in CSF prescribing among oncologists was observed.
    • Actual clinical practice, captured by the system, differed substantially from ASCO survey-reported behaviors.

    Conclusions:

    • Computerized clinical information systems effectively capture detailed oncologists' practice patterns.
    • ASCO physician practice survey data may not accurately reflect real-world clinical practice.
    • Significant deviations from ASCO growth factor guidelines persist, with considerable variation in CSF use.
    • Further Phase III trials are necessary to confirm potential clinical differences between G-CSF and GM-CSF.