ebcn meeting budapest, 24 september 2004 update on individual data monitoring projects

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EBCN Meeting Budapest, 24 September 2004 Update on individual data monitoring projects QT and SEED Antonio Ponti CPO Piemonte

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EBCN Meeting Budapest, 24 September 2004 Update on individual data monitoring projects QT and SEED Antonio Ponti CPO Piemonte Torino, Italy. - PowerPoint PPT Presentation

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Page 1: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

EBCN MeetingBudapest, 24 September 2004

Update on individual data monitoring

projects

QT and SEEDAntonio Ponti

CPO PiemonteTorino, Italy

Page 2: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

SEED and QT Audit Systems

Their aim is two-fold:

1) to favour the implementation of European Guidelines (with

training and certification implications), and

Page 3: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

SEED and QT Audit Systems

2) to provide a service to screening programmes and Breast Units to meet their management

and evaluation needs.

Page 4: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

Advantages of monitoringIndividual vs Aggregate

screening data (1)

- Use of common definitions and rules in the process of collecting

the minimum dataset: an “educational” process

Page 5: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

Advantages of monitoringIndividual vs Aggregate

screening data (2)

- Standard analysis of common dataset, including standard reports on European outcome measures

Page 6: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

Advantages of monitoringIndividual vs Aggregate

screening data (3)

- Much more flexible analytical approach

Page 7: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

Projects and Partners (6 Countries)

Center SEED3.8

QT1.1

Bremen Firenze Leuven London Luxembourg Marseille Ravenna Strasbourg Torino Valencia Wiesbaden

Page 8: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 9: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

To access SEED (on line)

www.cpo.it/seed

demo has about 100,000 screening episodes

Page 10: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 11: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 12: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 13: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

SEED ResultsSeven European programmes 1999-2001

%

Technical repeat rate 1.8

IM after assessment 1.6

Invasive Ca <= 10 mm 40.5

B / M ratio 0.27

E.G. standard

%

> 25.0

0.6

0.9

38.10.14

E.G. standard

< 1.0

> 30.0

%

124,555 FIRST TESTS 159,511 SUBS. TESTS

%

< 3.0

< 1.0< 1.0

Further assessment rate 6.0 2.9< 7.0 < 3.0

< 0.5 < 0.2

Page 14: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 15: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

To download QT

www.cpo.it/qt

www.eusoma.org

Page 16: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 17: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 18: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 19: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects
Page 20: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

Assessment Episodes Operated lesions

Total 5,513 1,450

10019629

10213096

154109113242No.

1792983400

4541563124042763811664No.

1228ValenciaTorinoStrasbourgRavennaMarseilleLuxembourgLondonLeuvenFirenzeBremenCenter

Wiesbaden

50-Budapest

Page 21: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0% 20% 40% 60% 80% 100%

Operation within 30 dd.Hormonal rec. available

Grading availableImmediate reconstruction

No axillary diss. in DCISMore than 9 lymph nodes

Clear margins 1 mm.Single operation

Cons. int. in DCIS <21mm.Cons. int. in pT1

No frozen section in Ca <11mmNo failed biopsy

Triple assessmentPreop. diagnosis 67,8

80,399,552,990,387,989,188,389,477,034,299,899,161,3

YES NO

Result %QT outcome measures

Page 22: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0% 20% 40% 60% 80% 100%

MLIHGFEDCBA 92,4

80,2

88,4

88,1

46,3

13,3

64,8

62,5

66,0

68,1

51,4

181

77

91

96

31

13

46

15

99

32

92

Positive preoperative cyto/histolog. diagnosis

Cancers with post-operative diagnosis

YES ? NO

Results %CENTERCENTER

Page 23: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0% 20% 40% 60% 80% 100%

MLIHGFEDCBA 92,4

80,2

88,4

88,1

46,3

13,3

64,8

62,5

66,0

68,1

51,4

181

77

91

96

31

13

46

15

99

32

92

Positive preoperative cyto/histolog. diagnosis

Cancers with post-operative diagnosis

YES NO

Results %CENTERCENTER

Page 24: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0% 25% 50% 75% 100%

A

B

C

D

E

F

G

H

I

L

M

FNA & Core biopsy (operated only)

FNA

?None

BothCBCE

NTE

RCE

NTE

R

Page 25: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0

20

40

60

80

100

0 20 40 60 80 100 120

B

C

D

F

G

I

L

All

Fine Needle AspirationAb

solu

teSe

nsiti

vity

Full Specificity

Page 26: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0

20

40

60

80

100

0 20 40 60 80 100

ABCDEFGILMAll

Pre-operative diagnosisAb

solu

teSe

nsiti

vity

Full Specificity

Page 27: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0 20 40 60 80 100

A

B

C

D

E

F

G

I

L

M

Time btw screening and assessment <= 3 weeks

Page 28: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

0 20 40 60 80 100

A

B

C

D

E

F

G

H

I

L

M

Time btw referral and surgery <= 30 days

Page 29: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

European Benchmarking

Within the project described we have attempted to bridge guidelines with screening and care evaluation, while providing databases useful for daily

management of screening programmes and patient care.

Page 30: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

European Benchmarking

This could serve as a model for other health care areas, particularly colon

and cervical cancer for which screening programmes are being

offered throughout Europe.

Page 31: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

European Benchmarking

Another bridge is being built: with Cancer Registries networks in the framework of population high

resolution studies.

Page 32: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

European Benchmarking

The quality cycle entails a continuous updating of the audit

tools in the framework of a comprehensive European activity.

Page 33: EBCN Meeting Budapest, 24 September 2004 Update on  individual data monitoring projects

European Benchmarking

In the meanwhile QT is freely available to anyone and SEED could

be used by local and regional screening programmes wishing to

mutually agree to share it and concur in its development.