How to publish your work in a peer-reviewed journal: A short guide

The basis of a manuscript is the research question, which is reported within a standard publication structure. The ‘Background’ section clarifies the question. The ‘Methods’ section describes what was done in the study. The ‘Results’ section describes the data observed and the analysis of these data. The ‘Discussion’ section describes how findings of the study relate to current knowledge and the practical implications of the results, and suggests future studies. This structure differs from that of a thesis, the aims of which are broader than reporting on a specific research question

Cost considerations in determining the affordability of adjuvant trastuzumab in breast cancer

The drug cost of adjuvant trastuzumab to benefit one patient with localised human epidermal growth factor receptor 2 (HER2)-positive breast cancer depends on the baseline survival rate (BLSR) of the prognostic group of the patient. This varies from ZAR13 752 900 (BLSR 90%) to ZAR4 006 100 (BLSR 60%). All treated patients are exposed to potential toxicity. The value and affordability of treatments need to be considered, as there are finite resources available in our healthcare system. All patients must have access to cost-effective treatments. However, patient selection for expensive treatments is important, as expenditure on patients where the gains are relatively small will result in resources not being available for other patients. The state, healthcare institutions and the pharmaceutical industry need to work together to optimise the benefits of treatment to patients

The cancer burden in Africa

Cancer is currently responsible for more than 7 million deaths per year worldwide, more than malaria, tuberculosis and HIV/AIDS combined. There are more than 600 000 deaths annually in Africa from cancer. In the developing world, the number of new cancer cases will increase significantly over the next 10 years. By 2020 there are expected to be 15 million new cases of cancer every year, 70% of which will be in developing countries, where governments are least prepared to address the growing cancer burden and where survival rates are often less than half those in more developed countries. African countries will account for over a million new cancer cases a year and they are the least able of all developing countries to cope, having fewest cancer care services

A quality improvement programme in radiotherapy using workflow audits

Background. Evaluation of the quality of healthcare depends on measures of structures, processes and outcomes. Progress in recording data allows for better measures of processes, such as the completeness of clinical data, the performance of professional tasks and the use of checklists.Objectives. To report the results of a radiotherapy (RT) workflow audit and a subsequent online survey of user experience.Methods. The RT workflow audit was developed in 2016 and has been undertaken twice a year at 28 facilities or units, with a total of 32 linear accelerators. Electronic patient folders were reviewed to assess the documentation of 90 task items, of which 64 were scored. The auditor came from another facility. The online survey took place in July 2020. It contained questions on the audit’s process, professional value and future use. Invitations were sent by email to the 151 radiotherapist staff at the 28 units where the audit had been implemented. Responses were anonymous.Results. For the RT workflow audit, scores improved from 60% in some units in 2016 to >90% in all units for at least 2 years since 2018. The number of responders to the online survey was 58, giving a responder rate of 38%. The margin of error of the results was 10%. The audit’s task items were considered appropriate by 77% of responders, and feedback was reported by 78% of them. The audit was considered very or extremely valuable to their unit’s service delivery by 58% of responders. Changes in the unit as a result of the audit were reported by 77% of responders. The audit was very useful or extremely useful to 75% of responders in maintaining personal professional standards. The proportion of responders who were very or extremely supportive of continuing with the audit was 77%. The comments in the online survey will be helpful for ongoing review of the RT workflow audit.Conclusions. The RT workflow audit extends the scope of accreditation audits by including measures of processes. Users of the audit evaluate its processes favourably and report that it has value both in their unit’s clinical service and for their personal professional standards. The audit is effective in developing quality improvement programmes

Adjuvant chemotherapy for stage I non-seminomatous testicular cancer

The International Society for Burns Injuries (ISBI) has published guidelines for the management of multiple or mass burns casualties, and recommends that 'each country has or should have a disaster planning system that addresses its own particular needs.' The need for a national burns disaster plan integrated with national and provincial disaster planning was discussed at the South African Burns Society Congress in 2009, but there was no real involvement in the disaster planning prior to the 2010 World Cup; the country would have been poorly prepared had there been a burns disaster during the event. This article identifies some of the lessons learnt and strategies derived from major burns disasters and burns disaster planning from other regions. Members of the South African Burns Society are undertaking an audit of burns care in South Africa to investigate the feasibility of a national burns disaster plan. This audit (which is still under way) also aims to identify weaknesses of burns care in South Africa and implement improvements where necessary

Radical irradiation for carcinoma of the prostate

Ninety-three patients treated by radical irradiation for stage A2, Band C1 carcinoma of the prostate between 1979 and 1988 at a joint radiotherapy service were reviewed. The average age was 63 years, 84% of the patients were white and on histological examination the tumours were well or moderately differentiated in 88% of cases. Treatment was with 5 fractions per week in 71% while the remainder received 3 - 4 fractions per week. At a median follow-up of 62 months, the 5-year survival rate was 83% and the relapse-free rate was 73% (life table). The most important prognostic factor was tumour grade. In patients with grade 1 and 2 tumours, the 5-year survival rate and relapse-free rate was 91% and 76% respectively, while the survival for grade 3 tumour was 60% and 22% respectively (P < 0,05 logrank). There was a suggestion that patients diagnosed by trans-rectal needle biopsy did better than those diagnosed by trans-urethral resection, but this was not statistically significant. Disease stage did not influence survival. The crude late complication rate was 10% but this was significantly related to the use of less than 5 fractions of radiation per week. A separate group of 13 patients with local disease who had had failed previous hormonal treatment were not analysed. Their 5-year survival rate was 19%, which is statistically significantly worse (P< 0,001 logrank)