From positive screen or symptoms to diagnosis (primary care/secondary care interface) Senior Researcher: Dr. Sander van Zanten
Objective: To examine the frequency of physician visits (particularly gastroenterology, family medicine and surgery) and the frequency of colonoscopy performed in the 24 months preceding the CRC diagnosis, and to describe the processes of care preceding the diagnosis.
Study summary
From diagnosis to surgery (primary care/secondary care interface)
Senior researcher: Dr. Geoff Porter
Objective: To determine the presence or absence of recognized pre-surgical quality indicators, such as appropriate preoperative imaging, full colon examination peri-operatively, and presentation in the emergency department, and to describe the process of care from diagnosis to surgery.
Study summary
From surgery to adjuvant chemotherapy (secondary care/tertiary care interface)
Senior researcher: Dr. Daniel Rayson
Junior researcher: Dr. Bruce Colwell
Objective: To study time intervals and concordance of care with clinical practice guidelines (CPGs) on adjuvant therapy for patients with early stage CRC.
Study summary
From surgery to adjuvant (or neo-adjuvant) radiotherapy (secondary care/tertiary care interface)
Senior researchers: Dr. Eva Grunfeld and Dr. Geoff Porter
Junior researchers: Dr. Dorianne Rheaume and Dr. Slawa Cwajna
Objective: To develop and pretest tools to improve quality of care for rectal cancer. The tools will involve synoptic templates for colonoscopy, surgery and pathology reports. Based on a review of the literature, existing tools will be adapted for use in the Nova Scotia setting and pretested.
Study summary
From treatment to follow-up and reentry for recurrence (primary/secondary/tertiary care interface)
Senior researcher: Dr. Eva Grunfeld
Junior researcher: Amy Folkes
Objective: To describe the frequency and providers of routine follow-up visits, the frequency of surveillance colonoscopy, and variations in follow-up practices by population characteristics. Additional objectives include studying the extent to which patients who develop recurrence undergo resection of liver and lung metastases and, for patients receiving routine follow-up in primary care who develop recurrence, their wait times for re-entry into secondary/tertiary care.
Study summary
From initial treatment to palliative care (primary/secondary/tertiary care interface)
Senior researchers: Dr. Grace Johnston and Dr. Fred Burge
Objective: To examine the health services used 6 months before death and describe variations in use by population characteristics. A second pilot study may be conducted using qualitative methods to understand what those with advanced CRC see as important markers of quality end-of-life care for them and their families.
Study summary
Vulnerable populations – adults with mental illness
Senior researcher: Dr. Steve Kisely
Objective: To compare age-standardized mortality rates, referral rates to oncology, initial admission rates for CRC, and incidence with the general population; to assess whether increased case fatality rates are due to later presentation of psychiatric patients with CRC; to conduct sensitivity analyses to assess the effect of the severity of psychiatric illness; and to study diagnostic time intervals, cancer centre referral, and treatment decisions and processes.
Study summary
Vulnerable populations – children/youth with solid tumour cancers
Senior researcher: Dr. Louise Parker
Junior researchers: Dr. Dorothy Barnard and Dr. Fergall Magee
Objective: To assemble a cohort of children/youth diagnosed with solid tumours and examine patterns of care in the 12 months preceding the cancer diagnosis. Additionally, to determine the proportion of patients eligible for clinical trials and the reason for ineligibility by chart review and to examine the transition to diagnosis and optimum therapy in children/youth with solid tumours.
Study summary
Knowledge translation (intra-NET and extra-NET)
Senior researchers: All investigators
Junior researcher: Mrs. Robin Urquhart
Objective: To evaluate the knowledge broker role via developing indicators to assess workplan success and network efficacy, completing daily reflective journals to collect contextual data on team interaction and participation, and conducting and analyzing semi-structured interviews with team researchers and decision/policy-makers.
Study summary
*Studies XX will use a population-based cohort of incident cases of CRC, diagnosed in Nova Scotia between 2000-05.