Table 5 Barrier analysis
From: A mixed methods approach to understand variation in lung cancer practice and the role of guidelines
Item | Rating | Mean | Sd | Mode | ||
|---|---|---|---|---|---|---|
Disagree | Neutral | Agree | ||||
a. Surgeons are reluctant to refer patients to a medical oncologist and/or radiation oncologist. | 85.0 | 2.5 | 12.5 | 1.8 | 1.4 | 1.0 |
b. The referral process to a cancer centre or cancer specialist is complex. | 76.2 | 11.9 | 11.9 | 2.5 | 1.6 | 1.0 |
c. The referral process to a cancer centre or cancer specialist is slow. | 53.8 | 15.4 | 30.8 | 3.6 | 1.8 | 3.0 |
d. The referral process to a cancer centre or cancer specialist is unreliable. | 82.5 | 7.5 | 10.0 | 2.3 | 1.5 | 1.0 |
e. Personal lack of clinical skill to implement the recommendations. | 90.2 | 4.9 | 4.9 | 1.6 | 1.3 | 1.0 |
f. Organizational support from the clinical administrator leaders exists in the institution to support the implementation of the recommendations. | 31.7 | 9.8 | 58.5 | 4.5 | 2.3 | 6.0a |
g. There is adequate medical expertise in their region to implement the recommendations. | 9.3 | 4.7 | 86.0 | 6.1 | 1.6 | 7.0 |
h. The patients in the studies comprising the evidentiary base do not reflect the typical patient they seen in the clinic. | 60.0 | 15.0 | 25.0 | 3.1 | 1.8 | 2.0 |
i. It is easy for patients in their region to access the recommended treatment | 23.1 | 5.1 | 71.8 | 5.1 | 1.6 | 5.0a |
j. The implementation of the recommendations will result in unacceptable levels of adverse effects for the typical resected stage II and IIIA NSCLC patients seen in practice. | 86.5 | 10.8 | 2.7 | 2.1 | 1.1 | 2.0 |
k. Optimizing the treatment of lung cancer patients is not as much of an organizational priority in their care setting as is the treatment of patients with other cancer diagnoses. | 66.7 | 17.9 | 15.4 | 2.6 | 1.7 | 1.0 |
l. The implementation of the recommendations will yield the anticipated benefits as per the recommendations/guideline. | 66.7 | 17.9 | 15.4 | 2.8 | 1.6 | 2.0 |
m. The recommendations are not cost effective. | 77.5 | 15.0 | 7.5 | 2.4 | 1.3 | 1.0 |