Merrylee McGuffin

Exploring Attitudes of Canadian Radiation Oncologists, Radiation Therapists, Physicists, and Oncology Nurses Regarding Interprofessional Teaching and Learning

The purposes of this exploratory study were to investigate the attitudes of radiation oncology professionals regarding interprofessional (IP) teaching and interprofessional education (IPE), to identify the challenges faced by radiation oncologists who teach within an IP context, and to discover new strategies to aid professionals teaching IP students. A questionnaire was developed through the review of existing literature on IPE using Medline. The proposed group of questions was selected by educators from different professions actively involved in IPE. The final revised questionnaire consisted of three main domains assessing the understanding of IP concepts, attitudes toward IP teaching and learning environments, and attitudes toward health-care teams. An open-ended comment section was included. The questionnaire was administered to health-care professionals (physicists, radiation oncologists, and radiation therapists) nationally through SurveyMonkey® (electronic survey). A total of 220 respondents provided demographic information. Half of these respondents indicated that they previously received education relating to IPE. A high level of agreement was received for nearly all the questions. There were no significant statistical differences among the three different professional respondent groups for any question. Overall, most of the respondents demonstrated a good knowledge and understanding of IP concepts and advocated IP training and collaboration.

Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer

AIMS Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. MATERIALS AND METHODS An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. RESULTS Overall, HDR was the most expensive (

Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation

14 400), followed by PBSI (

Decisional Support throughout the Cancer Journey for Older Women Diagnosed with Early Stage Breast Cancer: A Single Institutional Study

8700), with WBI proving the least expensive (

Prostate HDR Monotherapy: Initial Efficacy Results from a Randomized Trial of One versus Two Fractions

6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about

Permanent Breast Seed Implant for Early-stage Breast Cancer: Impact of Primary Tumour Location on the Overall Cosmetic Outcome

10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. CONCLUSIONS WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience.