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超越肉瘤中心:建立肉瘤HASM网络——一个用于全球综合和精准医疗的中心辐射型网络。

Beyond the sarcoma center: establishing the Sarcoma HASM network-a Hub and Spoke Model network for global integrated and precision care.

作者信息

Fuchs B, Gronchi A

机构信息

Sarcoma Center/IPU, Department of Orthopaedics and Trauma, LUKS University Hospital, Lucerne; Faculty of Health Research & Medicine, University of Lucerne, Lucerne, Switzerland.

Department of Surgical Oncology, Fondazione IRCCS, Istituto Nazionale die Tumori, Via Giacomo Venezian, Milano, Italy.

出版信息

ESMO Open. 2024 Dec;9(12):103734. doi: 10.1016/j.esmoop.2024.103734. Epub 2024 Dec 5.

DOI:10.1016/j.esmoop.2024.103734
PMID:39642636
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11666932/
Abstract

The landscape of sarcoma treatment has evolved significantly, transitioning from amputations to limb-sparing surgeries, underpinned by advancements in multidisciplinary strategies. The establishment of specialized sarcoma centers has been pivotal, though challenges in accessibility and expertise persist. This manuscript proposes the Sarcoma Hub and Spoke Model (HASM) network to address these issues, enhancing coordination and expanding access to specialized care. The HASM network centralizes complex case management at hubs while peripheral spokes manage routine diagnostics and treatments, optimizing resource use and ensuring patient-centered care. Integration with digital interoperable platforms facilitates real-time/real-world data exchange, supports multidisciplinary team meetings, and enables advanced predictive analytics such as Sarcoma Digital Twins and causal machine learning for personalized treatment. The Sarcoma Care Data Warehouse further enhances this model by aggregating comprehensive patient data, supporting quality assessment and continuous improvement. This innovative approach aims to set a new standard for sarcoma care, leveraging technology and collaborative expertise to improve outcomes globally.

摘要

肉瘤治疗领域已发生显著演变,从截肢手术过渡到保肢手术,这得益于多学科策略的进步。专门的肉瘤中心的建立至关重要,尽管在可及性和专业知识方面仍存在挑战。本手稿提出肉瘤中心辐射模型(HASM)网络以解决这些问题,加强协调并扩大获得专科护理的机会。HASM网络在中心集中管理复杂病例,而周边分支负责常规诊断和治疗,优化资源利用并确保以患者为中心的护理。与数字可互操作平台集成有助于实时/真实世界数据交换,支持多学科团队会议,并实现诸如肉瘤数字孪生和因果机器学习等先进的预测分析以进行个性化治疗。肉瘤护理数据仓库通过汇总全面的患者数据进一步完善该模型,支持质量评估和持续改进。这种创新方法旨在为肉瘤护理树立新标准,利用技术和协作专业知识改善全球治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a0b/11666932/2df585540a77/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a0b/11666932/175b1c31fbbf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a0b/11666932/2df585540a77/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a0b/11666932/175b1c31fbbf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a0b/11666932/2df585540a77/gr2.jpg

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本文引用的文献

1
Causal machine learning for predicting treatment outcomes.因果机器学习在预测治疗结果中的应用。
Nat Med. 2024 Apr;30(4):958-968. doi: 10.1038/s41591-024-02902-1. Epub 2024 Apr 19.
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The Next Frontier in Sarcoma Care: Digital Health, AI, and the Quest for Precision Medicine.肉瘤治疗的下一个前沿领域:数字健康、人工智能与精准医学探索
J Pers Med. 2023 Oct 25;13(11):1530. doi: 10.3390/jpm13111530.
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Enhancing Healthcare for Sarcoma Patients: Lessons from a Diagnostic Pathway Efficiency Analysis.提高肉瘤患者的医疗保健水平:诊断途径效率分析的经验教训。
Cancers (Basel). 2023 Oct 9;15(19):4892. doi: 10.3390/cancers15194892.
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Hub-and-Spoke centralized intervention to optimize colorectal cancer screening and follow-up: A pragmatic, cluster-randomized controlled trial protocol.中心辐射式集中干预优化结直肠癌筛查及随访:一项实用、群组随机对照试验方案。
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Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review.数字健康在癌症护理设施中心辐射型层级体系中协调患者护理的作用:一项范围综述
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Unlocking the Power of Benchmarking: Real-World-Time Data Analysis for Enhanced Sarcoma Patient Outcomes.解锁基准测试的力量:用于改善肉瘤患者预后的真实世界数据分析
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Defining the role of real-world data in cancer clinical research: The position of the European Organisation for Research and Treatment of Cancer.定义真实世界数据在癌症临床研究中的作用:欧洲癌症研究和治疗组织的立场。
Eur J Cancer. 2023 Jun;186:52-61. doi: 10.1016/j.ejca.2023.03.013. Epub 2023 Mar 21.