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A brain cancer pathway in clinical practice.

INTRODUCTION
Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works in the initial phase in a clinical setting with emphasis on pathway criteria.


MATERIAL AND METHODS
All patients admitted during the first two-year period to a regional neurology department in Denmark and fulfilling the IBCP inclusion criteria were included. Data regarding onset symptoms, diagnosis and time for diagnostic work-up were obtained and supplemented by a retrospective review of patient records. Sensitivities, specificities and positive predictive values of the inclusion criteria were calculated with magnetic resonance imaging scan of the cerebrum as index of validity.


RESULTS
The strength of the pathway inclusion criteria was determined largely by the number of criteria fulfilled and by the type of predominant symptoms. The criteria identified the majority of patients with symptomatic brain malignancy and were also highly predictive of general structural brain lesions.


CONCLUSION
The introduction of the pathway is a major step forward in the efforts to optimize brain cancer patients' illness trajectory.


FUNDING
This study was funded by a grant from the Danish Ministry of Health and Interior Affairs 2009 and the Helen Rude Foundation and has been approved by the Danish Data Protection Agency.


TRIAL REGISTRATION
not relevant.