PDF(Pubmed)
Abstract：
To identify key areas for research in prostate cancer (PC) in the Ugandan context by establishing the major health system, socioeconomic and clinical barriers to seeking, reaching and receiving high-quality cancer care.
Modified Delphi Technique.
Government and private-not-for-profit hospitals.
We applied a two-stage modified Delphi technique to identify the consensus view across cancer experts. In round 1, experts received a questionnaire containing 21 statements drawn from a systematic review identifying the reason for the delay in accessing cancer care. Each statement was scored out of 20. Statements scoring ≥15 from over 70% of participants were prioritised for inclusion while statements for which <30% of participants gave a score of ≥15 were excluded. Sixteen statements were included in round 2 as they did not receive consensus for inclusion or exclusion.
We found that the top six research priority areas arise from challenges including: (1) lack of diagnostic services-ultrasound, laboratory tests and biopsy facilities; (2) high costs of services, for example, surgery, radiotherapy, hormone therapy are unaffordable to most patients, (3) lack of essential medicines, (4) limited radiotherapy capacity, (5) lack of awareness of cancer as a disease and low recognition of symptoms, (6) low healthcare literacy. The lack of critical surgical supplies, high diagnostic and treatment costs were ranked highest in order of importance in round 1. Round 2 also revealed lack of diagnostic services, unavailability of critical medicines, lack of radiotherapy options, high costs of treatments and lack of critical surgical supplies as the top priorities.
These research priority areas ought to be addressed in future research to improve prompt PC diagnosis and care in Uganda. There is need to improve the supply of high-quality affordable anticancer medicines for PC patients so as to improve the survivorship from the cancer.
Modified Delphi Technique.
Government and private-not-for-profit hospitals.
We applied a two-stage modified Delphi technique to identify the consensus view across cancer experts. In round 1, experts received a questionnaire containing 21 statements drawn from a systematic review identifying the reason for the delay in accessing cancer care. Each statement was scored out of 20. Statements scoring ≥15 from over 70% of participants were prioritised for inclusion while statements for which <30% of participants gave a score of ≥15 were excluded. Sixteen statements were included in round 2 as they did not receive consensus for inclusion or exclusion.
We found that the top six research priority areas arise from challenges including: (1) lack of diagnostic services-ultrasound, laboratory tests and biopsy facilities; (2) high costs of services, for example, surgery, radiotherapy, hormone therapy are unaffordable to most patients, (3) lack of essential medicines, (4) limited radiotherapy capacity, (5) lack of awareness of cancer as a disease and low recognition of symptoms, (6) low healthcare literacy. The lack of critical surgical supplies, high diagnostic and treatment costs were ranked highest in order of importance in round 1. Round 2 also revealed lack of diagnostic services, unavailability of critical medicines, lack of radiotherapy options, high costs of treatments and lack of critical surgical supplies as the top priorities.
These research priority areas ought to be addressed in future research to improve prompt PC diagnosis and care in Uganda. There is need to improve the supply of high-quality affordable anticancer medicines for PC patients so as to improve the survivorship from the cancer.
摘要：
目的：通过建立主要的卫生系统，确定乌干达背景下前列腺癌（PC）研究的关键领域，寻求的社会经济和临床障碍，达到并接受高质量的癌症治疗。
方法：改进的德尔菲技术。
方法：政府和私营非营利医院。
方法：我们应用了两阶段改进的Delphi技术来确定癌症专家的共识观点。在第1轮中，专家们收到了一份问卷，其中包含21项陈述，这些陈述来自系统评价，确定了延迟获得癌症治疗的原因。每个陈述都得分为20分。超过70%的参与者评分≥15的陈述被优先纳入，而<30%的参与者评分≥15的陈述被排除。在第二轮中列入了16项声明，因为它们没有获得纳入或排除的共识。
结果：我们发现前六个研究优先领域来自挑战，包括：（1）缺乏诊断服务-超声，实验室检查和活检设施；(2)服务成本高，例如,手术,放射治疗,激素治疗对大多数患者来说是负担不起的，(3)缺乏基本药物，（4）放疗能力有限，（5）对癌症作为一种疾病缺乏认识，对症状认识低，（6）保健素养低。缺乏关键的手术用品，在第1轮中,高诊断和治疗费用按重要性排序最高.第二轮还显示缺乏诊断服务，无法获得关键药物，缺乏放射治疗选择，高昂的治疗费用和缺乏关键的手术用品是首要任务。
结论：在未来的研究中，这些研究优先领域应该得到解决，以改善乌干达的及时PC诊断和护理。有必要改善PC患者的高质量负担得起的抗癌药物的供应，以提高癌症的生存率。
方法：改进的德尔菲技术。
方法：政府和私营非营利医院。
方法：我们应用了两阶段改进的Delphi技术来确定癌症专家的共识观点。在第1轮中，专家们收到了一份问卷，其中包含21项陈述，这些陈述来自系统评价，确定了延迟获得癌症治疗的原因。每个陈述都得分为20分。超过70%的参与者评分≥15的陈述被优先纳入，而<30%的参与者评分≥15的陈述被排除。在第二轮中列入了16项声明，因为它们没有获得纳入或排除的共识。
结果：我们发现前六个研究优先领域来自挑战，包括：（1）缺乏诊断服务-超声，实验室检查和活检设施；(2)服务成本高，例如,手术,放射治疗,激素治疗对大多数患者来说是负担不起的，(3)缺乏基本药物，（4）放疗能力有限，（5）对癌症作为一种疾病缺乏认识，对症状认识低，（6）保健素养低。缺乏关键的手术用品，在第1轮中,高诊断和治疗费用按重要性排序最高.第二轮还显示缺乏诊断服务，无法获得关键药物，缺乏放射治疗选择，高昂的治疗费用和缺乏关键的手术用品是首要任务。
结论：在未来的研究中，这些研究优先领域应该得到解决，以改善乌干达的及时PC诊断和护理。有必要改善PC患者的高质量负担得起的抗癌药物的供应，以提高癌症的生存率。
