Improved survival with clinical guidelines? Evaluation of a quality register linked to clinical guidelines for ovarian cancer in the western health care region in Sweden between 1 September 1993 and 1 June 1998.
BACKGROUND
New clinical guidelines (CGs) for ovarian cancer in the western health care region in Sweden were established, beginning in September 1993 and still in effect.


METHODS
A retrospective evaluation of 5 years of quality registration linked to CGs for ovarian cancer in this region was undertaken. The study material comprised 718 patients. Relative survival rates for the studied patients were compared with National Cancer Register data for the western health care region during the same period. The National Cancer Register data were also used to compare survival rate during the studied period and the preceding 5-year period.


RESULTS
Relative 5-year survival rate in our material was 46.1%. Relative survival in western Sweden during the studied period was found to be improved compared with that during the preceding period (P<0.02).


CONCLUSIONS
The CGs have led to an improved, tighter organization, with fewer clinicians in special 'tumor teams' performing more aggressive tumor reduction surgery. Chemotherapy prescription is centralized, while the actual administration is decentralized. This has probably been important for the good 5-year survival results.
Akeson
Margaretha
M
Department of Obstetrics and Gynaecology at SAS, Borås, Sweden. margaretha.akeson@vgregion.se
Zetterqvist
Britt-Marie
BM
Holmberg
Erik
E
Horvath
György
G
D017024:Chemotherapy, Adjuvant; D003536:Cystadenocarcinoma / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D010052:Ovariectomy; D017410:Practice Guidelines as Topic; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome