Critical appraisal:Bastings L, Baysal O, Beerendonk CC, Braat DD, Nelen WL 2014

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Critical Appraisal

Article being appraised

Bastings L, Baysal O, Beerendonk CC, Braat DD, Nelen WL. Referral for fertility preservation counselling in female cancer patients. Hum Reprod 2014 Oct 10;29(10):2228-37 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25069500.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

What changes can be detected in fertility preservation (FP) counselling (FPC) over time and what are the determinants associated with the referral of newly diagnosed female cancer patients, aged 0 – 39 years, to a specialist in reproductive medicine for FPC?

Number of Patients:

233

A retrospective observational and questionnaire study in a Dutch university hospital. Data on all female cancer patients counselled for FP in this centre (2001 – 2013), as well as all newly diagnosed female cancer patients aged 0 – 39 years in the region (2009–2011) were collected.
Reported outcome(s):

Although the absolute number of patients receiving FPC increased over time,only 9.8% of all potential patients(aged0–39 years) were referred in 2011 and referral disparities were found with respect to patients’ age, cancer diagnosis and healthcare provider-related factors.

Results of outcome(s):

In 2011, a total of 9.8% of the patients were referred for FPC. Patients aged 20–29 years or diagnosed with breast cancer or lymphoma were referred more frequently compared with patients under the age of 20 years or patients diagnosed with other malignancies. The absolute numbers of patients receiving FPC increased over time. Healthcare provider-related determinants for low referral were not starting a discussion about fertility-related issues, not knowing where to refer a patient for FPC and not collaborating with patients’ associations.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
Moderate risk of bias Comments: The low referral rates and referral disparities reported in the current study indicate that there are opportunities to improve referral practices.


Size of effect
5 Reason for decision:
Relevance of evidence
2 Additional comments:
Result of appraisal

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Completed by

Dr Jessica Harris

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Article
Bastings L, Baysal O, Beerendonk CC, Braat DD, Nelen WL. Referral for fertility preservation counselling in female cancer patients. Hum Reprod 2014 Oct 10;29(10):2228-37 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25069500.
Assigned to
User:Antoinette.anazodo
Topic area
Guidelines:COSA:Cancer fertility preservation guidelines/Referral to fertility specialists
Clinical question
Form
Form:Critical appraisal


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