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2019冠状病毒病大流行期间癌症患者手术的优先排序:平衡行动失败的教训

Prioritization of Surgery in Cancer Patients During the COVID-19 Pandemic: Lessons From a Failed Balancing Act.

作者信息

Donckier Vincent, Estache Antonio, Liberale Gabriel, Goldman Michel

机构信息

From the Department of Oncological Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.

European Center for Advanced Research in Economics and Statistics (ECARES), Université Libre de Bruxelles, Brussels, Belgium.

出版信息

Ann Surg Open. 2021 Dec 14;2(4):e108. doi: 10.1097/AS9.0000000000000108. eCollection 2021 Dec.

Abstract

The prioritization of surgical oncology over other elective interventions during COVID-19 has failed to preserve the quality of care in oncology and will likely lead to an increase of cancer-related mortality in the coming years. We propose five components for systems to improve the organization of surgical oncology during future crises, namely (1) a multidisciplinary governance structure employing predictive models and risk/benefit evaluations, (2) predefined quality objectives based on measurable markers (regularly reviewed and adapted), (3) temporary flexibility in therapeutic algorithms and authorization procedures (with associated safeguards), (4) systems to ensure access to transparent, apolitical information, and (5) explicit, dedicated logistical surgical capacities to optimize coordination and resource allocation.

摘要

在新冠疫情期间将外科肿瘤学置于其他选择性干预措施之上,未能维持肿瘤学护理质量,且可能在未来几年导致癌症相关死亡率上升。我们提出了五个系统组成部分,以在未来危机期间改善外科肿瘤学的组织架构,即:(1)采用预测模型和风险/效益评估的多学科治理结构;(2)基于可测量指标的预定义质量目标(定期审查和调整);(3)治疗算法和授权程序的临时灵活性(并设有相关保障措施);(4)确保获取透明、无政治倾向信息的系统;(5)明确、专门的后勤手术能力,以优化协调和资源分配。

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