Santa Maria della Misericordia University Hospital, ASUFC, Udine, Italy.
Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy.
JCO Precis Oncol. 2023 Sep;7:e2300166. doi: 10.1200/PO.23.00166.
Precision oncology (PO) promises positive results for patients. To date, in Italy, the effort to implement PO has been made autonomously by regional health institutions in a top-down fashion. This approach is not very efficient and jeopardizes patients' equal access to PO. Similar outcomes have been recorded in other Western countries. We tested a method of collaboration among professionals, scientific societies, and government institutions to facilitate the delivery of PO innovation to patients' bedsides.
We designed an organizational research project on the basis of a bottom-up approach. We started by observing PO-related activities in five health care authorities (HCAs) in one Italian region. We then compared the issues that emerged with those of three additional HCAs in other Italian regions. Using the results of the initial observation and adopting validated multiple-step consensus methods, we finally derived 14 statements that were approved by the four main scientific societies of oncology and pathology at the national level.
The 14 statements addressed the main issues linked to the implementation of PO in clinical practice. The strong professional consensus advocated for prompt adoption within the national healthcare system.
The consensus on the statements that were obtained shows the importance of a synergistic effort among professionals, scientific societies, and health care institutions in defining homogeneous solutions for innovation implementation within the health care system.
精准肿瘤学（PO）有望为患者带来积极的结果。迄今为止，在意大利，各地区卫生机构自主采取自上而下的方式来实施 PO。这种方法效率不高，危及患者平等获得 PO 的机会。在其他西方国家也有类似的结果记录。我们测试了一种专业人员、科学协会和政府机构之间合作的方法，以促进将 PO 创新送到患者床边。
我们基于自下而上的方法设计了一项组织研究项目。我们首先观察了意大利一个地区的五个卫生保健管理局（HCAs）中与 PO 相关的活动。然后，我们将出现的问题与其他三个意大利地区的 HCAs 的问题进行了比较。我们利用初始观察的结果，并采用经过验证的多步骤共识方法，最终得出了 14 项声明，这些声明得到了全国范围内四家主要肿瘤学和病理学科学协会的认可。
这 14 项声明涉及到将 PO 应用于临床实践中的主要问题。强烈的专业共识主张在国家医疗保健系统中迅速采用。
所获得的声明的共识表明，在医疗保健系统中为创新实施制定统一解决方案方面，专业人员、科学协会和医疗机构之间的协同努力非常重要。
