ASCO: Reform the 'clinical pathways' approach to cancer
- The American Society for Clinical Oncology (ASCO) on Tuesday released a new policy statement, recommending reform of the 'clinical pathways' approach to oncology in order to improve patient care.
- There are thousands of clinical pathways built around the 'if-then,' approach, designed to guide physicians towards proper patient treatment. But the pathways can be riddled with shortcomings and conflicts of interests, hindering their use in serving patients.
- Providers may be faced with multiple pathways, created by different groups with different agendas. ASCO claims the guidance can be too "rigid and inconsistent."
The existing set of clinical pathways is very challenging for oncologists, who must explain a choice to the patient as well as convincing payers their choice is the best approach. While ASCO points out that well-designed pathways work, the organization argues clinical pathways have become widely varied in quality and created a "major administrative burden" for doctors. Additionally, there are no guarantees ensuring guidance doesn't present conflicts of interest.
In its statement, ASCO pushes for the development of a consistent, transparent set of pathways. The organization also wants a nationwide effort to reduce the administrative burden and make pathways flexible to allow doctors more choice.
In June 2015, ASCO also released a tool allowing oncologists to compare prices, survival rates, and side effects of treatments for four common cancers.
There are other movements underway to reform the system, including from activist-oncologists, such as Dr. Vincent T. DeVita Jr., the former director of the National Cancer Institute. His book, "The Death of Cancer," makes the case for overcoming inefficient clinical pathways.