title: How accurate are medical oncologists' impressions of management of metastatic colorectal cancer in Australia?
abstract: OBJECTIVE
  Current efforts to understand patient management in clinical practice are largely based on clinician surveys with uncertain reliability. The TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) database is a multisite registry collecting comprehensive treatment and outcome data on consecutive metastatic colorectal cancer (mCRC) patients at multiple sites across Australia. This study aims to determine the accuracy of oncologists' impressions of real-word practice by comparing clinicians' estimates to data captured by TRACC.
  
  
  METHODS
  Nineteen medical oncologists from nine hospitals contributing data to TRACC completed a 34-question survey regarding their impression of the management and outcomes of mCRC at their own practice and other hospitals contributing to the database. Responses were then compared with TRACC data to determine how closely their impressions reflected actual practice.
  
  
  RESULTS
  Data on 1300 patients with mCRC were available. Median clinician estimated frequency of KRAS testing within 6 months of diagnosis was 80% (range: 20-100%); the TRACC documented rate was 43%. Clinicians generally overestimated the rates of first-line treatment, particularly in patients over 75 years. Estimate for bevacizumab in first line was 60% (35-80%) versus 49% in TRACC. Estimated rate for liver resection varied substantially (5-35%), and the estimated median (27%) was inconsistent with the TRACC rate (12%). Oncologists generally felt their practice was similar to other hospitals.
  
  
  CONCLUSIONS
  Oncologists' estimates of current clinical practice varied and were discordant with the TRACC database, often with a tendency to overestimate interventions. Clinician surveys alone do not reliably capture contemporary clinical practices in mCRC.
authors.affiliation: Department of Medical Oncology, Western Hospital, Melbourne, Australia.
authors.forename: Lewis
authors.initials: L
authors.lastname: Au
authors.affiliation: Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.
authors.forename: Natalie
authors.initials: N
authors.lastname: Turner
authors.affiliation: Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.|The Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Hui-Li
authors.initials: HL
authors.lastname: Wong
authors.affiliation: The Royal Melbourne Hospital, Melbourne, Australia.|Department of Medicine, University of Melbourne, Melbourne, Australia.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Field
authors.affiliation: Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.|The Royal Melbourne Hospital, Melbourne, Australia.|Department of Medicine, University of Melbourne, Melbourne, Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Lee
authors.affiliation: Royal Hobart Hospital, Hobart, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Boadle
authors.affiliation: Department of Medical Oncology, Eastern Health, Melbourne, Australia.
authors.forename: Prasad
authors.initials: P
authors.lastname: Cooray
authors.affiliation: Campbelltown Hospital, Sydney, Australia.
authors.forename: Deme
authors.initials: D
authors.lastname: Karikios
authors.affiliation: Department of Medical Oncology, Western Hospital, Melbourne, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kosmider
authors.affiliation: Cabrini Health, Melbourne, Australia.
authors.forename: Lara
authors.initials: L
authors.lastname: Lipton
authors.affiliation: Royal Hobart Hospital, Hobart, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Nott
authors.affiliation: Department of Medical Oncology, Eastern Health, Melbourne, Australia.|Faculty of Medicine, Nursing and Health Sciences, Eastern Health Clinical School, Monash University, Box Hill, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Parente
authors.affiliation: Department of Medical Oncology, Western Hospital, Melbourne, Australia.|Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.|The Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Tie
authors.affiliation: Department of Medical Oncology, Western Hospital, Melbourne, Australia.|Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.|The Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Tran
authors.affiliation: Department of Medical Oncology, Eastern Health, Melbourne, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Wong
authors.affiliation: Canberra and Calvary Hospitals and ANU Medical School, Canberra, Australia.
authors.forename: Desmond
authors.initials: D
authors.lastname: Yip
authors.affiliation: Cabrini Health, Melbourne, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Shapiro
authors.affiliation: Department of Medical Oncology, Western Hospital, Melbourne, Australia.|Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.|The Royal Melbourne Hospital, Melbourne, Australia.|BioGrid Australia, Melbourne, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Gibbs
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072103:Oncologists / Q000592:standards*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: accuracy; clinician; colorectal cancer; data collection; surveys