Quality Initiative in Rectal Cancer (QIRC) Trial
|ClinicalTrials.gov Identifier: NCT00182130|
Recruitment Status : Unknown
Verified July 2005 by McMaster University.
Recruitment status was: Active, not recruiting
First Posted : September 16, 2005
Last Update Posted : September 16, 2005
|Condition or disease||Intervention/treatment|
|Rectal Cancer||Procedure: Quality Initiative in Rectal Cancer (QIRC) strategy|
Approximately 5000 Canadians are annually diagnosed with rectal cancer. For patients undergoing rectal cancer surgery two unfortunate outcomes are permanent colostomy and local tumor recurrence. Research demonstrates that in Ontario, Canada and other parts of the world the standard of care for rectal cancer surgery leaves room for improvement.
This is a multi-center trial that will test if a set of interventions designed to positively influence surgeon practice, titled the Quality Initiative in Rectal Cancer (QIRC) strategy, can improve rates of permanent colostomy and local tumour recurrence for surgically treated rectal cancer patients. Secondary outcomes to be assessed include sexual, bowel, and bladder function, and quality of life. The QIRC strategy consists of a workshop to discuss quality issues in rectal cancer, operative demonstration to demonstrate optimal surgical techniques, the use of opinion leaders, and a postoperative questionnaire designed to prompt surgeons to re-examine their key operative steps. The QIRC strategy is largely designed to teach total mesorectal excision, a new gold standard for rectal cancer surgery that has been shown in non-randomized studies to lower patient rates of permanent colostomy and local tumour recurrence.
Sixteen hospitals across the province of Ontario were allocated by cluster randomization to the QIRC strategy (experimental arm) versus minimal intervention (control arm). All hospitals are high-volume centres - an annual rectal cancer procedure volume of 15 or greater. Hospitals in the control arm represent the normal practice environment. Approximately 700 patients will be assessed. In addition to measuring rates of permanent colostomy and local recurrence of tumour, the study will examine bowel, bladder and sexual function, and overall quality of life among patients.
A positive trial – better results in hospitals that receive the intervention – may suggest that to effectively influence surgeon practice, resource intense approaches are necessary along with active buy-in from the surgical community.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||691 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Quality Initiative in Rectal Cancer (QIRC) Trial|
|Study Start Date :||May 2002|
|Estimated Study Completion Date :||June 2007|
- Hospital rate of permanent colostomy
- Hospital rate of local recurrence
- Bowel, bladder and sexual function
- Quality of life
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00182130
|Principal Investigator:||Marko Simunovic, MD||McMaster University|