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癌症管理中实施下一代测序的潜在障碍:一项基于美国医生的调查。

Potential barriers to implementation of next-generation sequencing in cancer management: a U.S. Physician-based survey.

作者信息

Hussain Arif, Szamreta Elizabeth, Ning Ning, Kaminski Allysen, Shah Ruchit, Aggarwal Jyoti, Adeboyeje Gboyega

机构信息

Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Outcomes Research, Merck & Co, Rahway, NJ, USA.

出版信息

Future Oncol. 2025 Jan;21(2):231-239. doi: 10.1080/14796694.2024.2430725. Epub 2024 Nov 28.

Abstract

BACKGROUND

The purpose of this study was to identify barriers to physicians' NGS use and preferred strategies to alleviate these barriers.

RESEARCH DESIGN AND METHODS

A cross-sectional online survey link was sent to a sample of US oncologists/hematologists, surgeons, and pathologists identified through a panel. The survey collected data, from October-December 2020, on barriers to NGS testing and potential strategies.

RESULTS

Two hundred physicians participated (mean age: 46.2 years; 65% male; 80% White, mean years in clinical practice: 13.7). Despite the use of NGS testing by all physicians, 99.5% reported concerns/barriers. Reimbursement challenges were the most cited reason (87.5%), followed by lack of knowledge of NGS testing methodologies (81.0%), and lack of clinical utility evidence (80.0%). The most common reimbursement challenge was prior authorizations for NGS testing (72.0%), followed by knowledge of new fee codes for reimbursement or corresponding therapy (68.0%), and paperwork/administrative duties (67.5%). Surgeons were more likely to encounter challenges in using NGS testing than other physicians.

CONCLUSIONS

The results highlight the barriers reported by oncologists/hematologists, pathologists, and surgeons, which may impact the evolving role of NGS in the context of the overall management of cancer patients.

摘要

背景

本研究的目的是确定医生使用二代测序(NGS)的障碍以及缓解这些障碍的首选策略。

研究设计与方法

通过一个专家小组确定了美国肿瘤学家/血液学家、外科医生和病理学家的样本,并向他们发送了一份横断面在线调查链接。该调查在2020年10月至12月期间收集了关于NGS检测障碍和潜在策略的数据。

结果

200名医生参与了调查(平均年龄:46.2岁;65%为男性;80%为白人,平均临床工作年限:13.7年)。尽管所有医生都使用了NGS检测,但99.5%的医生报告了担忧/障碍。报销难题是最常被提及的原因(87.5%),其次是对NGS检测方法缺乏了解(81.0%)以及缺乏临床效用证据(80.0%)。最常见的报销难题是NGS检测的预先授权(72.0%),其次是对新报销费用代码或相应治疗的了解(68.0%)以及文书工作/行政职责(67.5%)。与其他医生相比,外科医生在使用NGS检测时更有可能遇到挑战。

结论

研究结果突出了肿瘤学家/血液学家、病理学家和外科医生报告的障碍,这些障碍可能会影响NGS在癌症患者整体管理背景下不断演变的作用。

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