- Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
for patients with a history of cancer (any) should patients undergoing a screening pet scan have antibiotics prior to scanning to decrease the false positive node rate in the head and neck? how often should these scans be done?
- Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
yes
- If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
clinical exam vs, screening pet scan & nodal biopsy if (+) , vs pet scan (pretx with abx) & nodal biopsy if (+)
- What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
all cancer patients without head and neck primaries (lymphoma, leukemia, breast, GU etc)
- Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
- Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
avoiding unnecessary surgery
- Describe any health-related risks, side effects, or harms that you are concerned about.
avoiding unnecessary surgery
Appropriateness for EHC Program
- Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
yes
- Which priority area(s) and population(s) does this topic apply to? (check all that apply)
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- EHC Priority Conditions (updated in 2008)
- Cancer
- AHRQ Priority Populations
- None
- Federal Health Care Program
- None
Importance
- Describe why this topic is important.
PET scans are increasignly being used to look for cancer recurrence but have lots of false positives; they are expensive, use a radionucleide tag, and can lead to aggressive intervention
- What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
finding that a number of cancer patients in our institution are getting q6 month pet scans, undergoing surgeyr for node removal, and have yet to see a true positive.
- Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
yes
- If yes, please explain:
Potential Impact
- How will an answer to your research question be used or help inform decisions for you or your group?
i think we need a better sense of the true + rate of pet and if it shoudl be ordered as a routine screen or only in conjunction with clinical indicators of recurrence
- Describe the timeframe in which an answer to your question is needed.
non urgent
- Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.
Nominator Information
- Other Information About You: (optional)
-
- Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
i think we need a better sense of the true + rate of pet and if it shoudl be ordered as a routine screen or only in conjunction with clinical indicators of recurrence
- Are you making a suggestion as an individual or on behalf of an organization?
Individual
- Please tell us how you heard about the Effective Health Care Program