SGO Issues March 23, 2017
Researcher explains why proposed NIH cuts should worry nation
Annual Meeting slides available through app and SGO ConnectEd
Journal article explores value of gynecologic oncology practice
SGO signs on to NSPSS statement on Surgical Patient Safety
SGO Annual Meeting has third straight year of record attendance
#Trials4GynCancerNow social media campaign launched
In an op-ed published in yesterday’s New York Times, Harold Varmus, Nobel Prize recipient and former director of both the National Institutes of Health and National Cancer Institute, criticized President Trump’s intention to cut the NIH budget by 18.3 percent (about $5.8 billion). At a time when NIH budget reductions have already impacted scientific research—which SGO has highlighted in a document specific to gynecologic oncology clinical trials—Varmus noted, “A substantial NIH budget cut would undermine the fiscal stability of universities and medical schools, many of which depend on NIH funding; it would erode America’s leadership in medical research; and it would diminish opportunities to discover new ways to prevent and treat diseases.”
Although Varmus acknowledges that the budget in its current form is unlikely to pass through Congress, he warned that even a compromise deal could result in a steep reduction for NIH funding.
“As I have learned from my own time at the NIH, this is not about Republicans versus Democrats,” said Varmus. “It is about a more fundamental divide, between those who believe in evidence as a basis for life-altering and nation-defining decisions and those who adhere unflinchingly to dogma. It is about a conception of national leadership that connects our economic success and our security to the generation of knowledge, and to the arts and sciences, not just to our military strength.”
Slide presentations from the 2017 Annual Meeting on Women’s Cancer are currently being uploaded to the SGO 2017 app and the online Annual Meeting portal for all meeting attendees and SGO members. All presentations made available by presenting authors will be available online through Thursday, June 15; after this date, requests for the slides should be addressed directly to the presenters. In one month, SGO will send an email announcing the availability of recordings from select Annual Meeting sessions, which will be available through ConnectEd, SGO’s peer reviewed eLearning portal. These recordings will be free and automatically available to meeting attendees through the “My ConnectEd Account” tab. A registered ConnectEd login will be necessary to access these recordings, but registration is free.
As value-based care becomes increasingly critical to health care delivery, alternative payment models (APMs) will be needed for future physician reimbursement, according to the authors of The ‘value’ of value in gynecologic oncology practice in the United States: Society of Gynecologic Oncology evidence-based review and recommendations, which is now available online and will be published in the April 2017 edition of Gynecologic Oncology.
The article, written by lead author David E. Cohn, MD, with Emily Ko, MD; Larissa A. Meyer, MD, Jason D. Wright, MD; Sarah M. Temkin, MD; Jonathan Foote, MD; Nathaniel L. Jones, MD; and Laura J. Havrilesky, MD, describes several efforts by SGO to address and assess value-based gynecologic cancer care.
For example, for APMs specific to women with gynecologic malignancies, endometrial cancer (EC) has been considered an initial prototype for gynecologic cancer care.
According to the article: “The endometrial cancer care model will form the basis of a bundled care pathway, and secondarily, form components of care upon which quality metrics will be built. As the treatment of EC includes surgery, chemotherapy, radiation, genetics, surveillance and other components of care, the APM model for EC has been divided into episodes of care, with a focus first on the surgical treatment of EC.”
Once the EC model is finalized, the APM will be presented to public or private payers for consideration of piloting this bundled payment model.
Other efforts to assess value-based gynecologic cancer care include applying the American Society of Clinical Oncology (ASCO) value framework to ovarian cancer, which is based on data gathered from Gynecologic Cancer Group trial 218. GOG 218 compared standard carboplatin + paclitaxel (CP) chemotherapy versus concurrent plus maintenance bevacizumab with CP.
The SGO Choosing Wisely Top 5 list of tests and procedures that should be questioned, released in October 2013, also provides a basic framework for value-based care in gynecologic oncology. Dr. Cohn noted that there is some data that has come out over the last four years that could be incorporated into an updated list.
Dr. Cohn added that despite the expected transition from the Affordable Care Act (ACA) to a replacement, the issues that are being considered under Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)—which includes APMs and the Merit-based Incentive Payment System (MIPS)—are not impacted because this is a separate law that HHS and CMS are implementing.
The components of payment reform are expected to remain fairly stable regardless of what happens with the ACA,” said Dr. Cohn.
Last month the SGO leadership formally endorsed an information statement on Surgical Patient Safety that was a consensus opinion produced by the National Surgical Patient Safety Summit (NSPSS) in August 2016. The summit was sponsored by the American College of Surgeons (ACS) and the American Academy of Orthopaedic Surgeons (AAOS) with support from the American Society of Anesthesiologists (ASA) and Association of periOperative Registered Nurses (AORN).
According to the statement: “NSPSS believes that surgical patient safety is the highest priority for all surgical professional and other stakeholder organizations. Participants in NSPSS support the following proposed surgical safety standards as ‘core competencies’ to improve surgical patient safety and outcomes.”
Work groups assessed the literature and proposed standards in the following domains:
1. Key Safety Definitions and Processes
2. Essential Safety Behaviors, Human Factors, Organizational Culture
3. Safety Data and Performance Measurement
4. Safety Education (Individual, Team and Organization/Facility-based) Programs
More than 150 representatives from 75 healthcare organizations attended the summit. SGO was represented by Mark Genesen, MD, from Loma Linda University Cancer Center in Loma Linda, CA.
The 2017 SGO Annual Meeting on Women’s Cancer in National Harbor, MD, marked the third year in a row with record attendance. This year there were 2,466 total attendees (including 460 international attendees) and 57 exhibiting companies on a sold out show floor. A total of 475 abstracts were presented at this year’s meeting. SGO news releases, media coverage and video interviews are available on the SGO website.
During last week’s SGO Annual Meeting, attendees were asked to raise awareness about the crisis in gynecologic oncology clinical trials—an initiative to be continued throughout the presidency of Laurel Rice, MD. The launch of the social media campaign included tweets to President Trump: “Women with #gyncancer deserve progress. Fund trials now @realDonaldTrump #Trials4GynCancerNOW @sgo_org.” Other attendees visited the SGO booth in the Exhibit Hall to take their photo with the hashtag poster for a chance to win a free registration to the 2018 Annual Meeting in New Orleans. The winner of that contest will be announced in the next SGO Issues.