Lyons Kathleen Doyle, Radomski Mary Vining, Alfano Catherine M, Finkelstein Marsha, Sleight Alix G, Marshall Timothy F, McKenna Raymond, Fu Jack B
Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Department of Psychiatry, Dartmouth College, Hanover, NH.
Courage Kenny Research Center, Minneapolis, MN.
Arch Phys Med Rehabil. 2017 May;98(5):904-914. doi: 10.1016/j.apmr.2016.11.015. Epub 2016 Dec 19.
To solicit expert opinions and develop consensus around the research that is needed to improve cancer rehabilitation for older adults.
Delphi methods provided a structured process to elicit and prioritize research questions from national experts.
National, Web-based survey.
Members (N=32) of the American Congress of Rehabilitation Medicine completed at least 1 of 3 investigator-developed surveys.
Not applicable.
In the first survey, participants identified up to 5 research questions that needed to be answered to improve cancer rehabilitation for older adults. In 2 subsequent surveys, participants viewed the compilation of questions, rated the importance of each question, and identified the 5 most important questions. This generated priority scores for each question. Consensus scores were created to describe the degree of agreement around the priority of each question.
Highest priority research concerns the epidemiology and measurement of function and disability in older adult cancer survivors; the effects of cancer rehabilitation interventions on falls, disability, participation, survival, costs, quality of care, and health care utilization; and testing models of care that facilitate referrals from oncology to rehabilitation providers as part of coordinated, multicomponent care.
A multipronged approach is needed to fill these gaps, including targeted funding opportunities developed with an advisory panel of cancer rehabilitation experts, development of a research network to facilitate novel collaborations and grant proposals, and coordinated efforts of clinical groups to advocate for funding, practice change, and policy change.
征求专家意见并围绕改善老年癌症患者康复所需的研究达成共识。
德尔菲法提供了一个结构化的过程，以从全国专家那里引出研究问题并确定其优先级。
基于网络的全国性调查。
美国康复医学大会的成员（N = 32）完成了由研究人员制定的3项调查中的至少1项。
不适用。
在第一次调查中，参与者确定了多达5个为改善老年癌症患者康复需要回答的研究问题。在随后的2项调查中，参与者查看了问题汇编，对每个问题的重要性进行评分，并确定了5个最重要的问题。这为每个问题生成了优先级分数。创建了共识分数以描述围绕每个问题优先级的一致程度。
优先级最高的研究涉及老年癌症幸存者功能和残疾的流行病学及测量；癌症康复干预对跌倒、残疾、参与度、生存率、成本、护理质量和医疗保健利用的影响；以及测试作为协调多成分护理一部分促进从肿瘤学向康复提供者转诊的护理模式。
需要采取多管齐下的方法来填补这些空白，包括与癌症康复专家咨询小组共同制定有针对性的资金机会，建立一个研究网络以促进新的合作和资助申请，以及临床团体为争取资金、实践变革和政策变革而做出的协调努力。
