Critical appraisal:Winkelman WD, Rosen MP, Mok-Lin E 2018

Critical Appraisal

Article being appraised

Winkelman WD, Rosen MP, Mok-Lin E. Fertility Preservation Services for Women With Newly Diagnosed Cancer: A National Assessment. Am J Clin Oncol 2018 Oct;41(10):1031-1035 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29315172.

Applicable clinical question

• What is the best practice approach for developing and implementing oncofertility services in relation to referral pathways and models of care?

Key Facts

Study Design

cross sectional study

Study aims:

To survey members of the Society for Assisted Reproductive Technologies, and assess the resources available for cancer patients once referred for fertility preservation.

Number of Patients:

99

Medical directors, practice directors, and laboratories directors of clinics that are members of the Society for Assisted Reproductive Technology (SART), representing 84 ICF centres.

Reported outcome(s):

The survey included questions regarding clinic setting, patient volume, services offered for fertility preservation, resources available for patients, and the presence of outreach programs for patients.

Results of outcome(s):

- Majority of IVF centres received less than 20 cancer referrals annually.
- Centres that receive the highest numbers of cancer referrals are more likely to be associated with a university/academic institution.
- Only about 22 centres (of the 84 clinics that responded) offer OCTP, most offer OOCP or embryo cryopreservation (96 and 97% respectively)
- 76% of clinics reported that they are able to see patients within 24-48 hrs of referral
- The 28 clinics that receive >20 oncology referrals annually are more likely to provide a designated patient navigator (χ2=13.31, P<0.01); hold live educational presentations (χ2=17.14, P<0.01); offer financial support (χ2=7.53, P=0.01); more likely to have long-term follow-up (χ2=5.67, P<0.01); more likely to have cancer patients return to take advantage of their treatment (χ2=11.26, P<0.01).

Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias

High risk of bias

Comments: Due to low participation rate, risk of bias is high.

Size of effect

1	Reason for decision:

Relevance of evidence

2	Additional comments:

Result of appraisal

Included

Comments

IVF centres are more likely to have referrals when a patient navigator is involved, and when they have an affiliation with an academic institution.

Completed by

Yasmin Jayasinghe

This appraisal has been completed.

Article

Winkelman WD, Rosen MP, Mok-Lin E. Fertility Preservation Services for Women With Newly Diagnosed Cancer: A National Assessment. Am J Clin Oncol 2018 Oct;41(10):1031-1035 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29315172.

Assigned to

User:Yasmin.jayasinghe

Topic area

Guidelines:COSA:Cancer fertility preservation guidelines/Oncofertility service development

Clinical question

• What is the best practice approach for developing and implementing oncofertility services in relation to referral pathways and models of care?

Form

Form:Critical appraisal

Section below only relevant for Cancer Council Project Officer

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