Exploring the integration of patient-reported outcome measures in clinical practice: A cross-sectional survey of EORTC healthcare professionals.

Using patient reported-outcome measures (PROMs) in routine care has significant potential to benefit patients with cancer, but it is unclear how widely they are used in practice. We conducted a cross-sectional survey (November 2023-April 2024) among healthcare professionals (HCPs) in the European Organisation for Research and Treatment of Cancer (EORTC). Descriptive statistics and chi-square tests assessed PROM use patterns, regional differences, and barriers. Binary regression models compared barriers between PROM users and non-users. Of the 3733 EORTC members contacted, 784 responded (21 % response rate), predominantly physicians. Among the 784 HCPs (50 % women), 338 (43 %) did not use PROMs, 214 (27 %) were occasional users, and 232 (30 %) used PROMs regularly. PROM use was significantly higher in Western Europe than in Central/Eastern Europe. PROMs were primarily used for monitoring health status and enhancing communication. PROM use was highest among HCPs treating bone, soft tissue, genito-urinary, and gynecological cancers, and lowest in lung cancer. Key barriers to PROM use included lack of time (reported by 70 % of respondents) and insufficient support on how to use PROMs (73 %). Compared to non-users, PROM users more frequently identified patient-level barriers, such as accessibility concerns, as relevant (Odds Ratio 3.5, 95 % Confidence Interval 2.4-5.3). PROM use varies by cancer type, setting, and region. Addressing time constraints, providing support, and overcoming patient barriers are key to broader integration. Ensuring equitable access to PROM tools across regions and settings is vital for promoting equity in cancer care

European Competition Policy in International Markets

International audienceChanges in the institutional, technological and economic environment raise new challenges to the European competition policy. In this context, it is timely for European authorities to appraise the external dimension of the European competition policy as well as its articulation with current internal reforms. Globalisation can increase the costs of monitoring and seriously reduce the ability of European authorities to tackle cross-border anti-competitive conducts. In addition, conflicts are exacerbated by industrial policy motivations. As it is unlikely that the sole application of the territoriality and extraterritoriality principles to competition rules could yield an optimal international competition system, globalisation calls for higher levels and types of cooperation. Given that bilateral cooperation and especially the implementation of comity principles could be of no value when laws or interests are sources of international conflicts, three main paths could be therefore encouraged: The continuous harmonization of rules through the joint action of OECD and ICN; the higher cooperation in the confidential information exchange; the establishment of global anti-trust institutions. Although WTO is legitimate in judging questions related market access and entry barriers, it is less equipped to assess international hard core cartels or M&A reviews. As a substitute for WTO, a multilevel system, like the EU system, could be promoted. For political and pragmatic reasons, it could be composed in a first step of a hard core of countries like the EU, Japan and the U.S. It could be associated with the creation of an international Court of Justice for competition. In addition to these external reforms, some internal reforms could be required. Competition authorities have to develop further competition advocacy to give a higher priority to competition issues in other EU policies and national regulation. A parallel and complementary reform could consist in making the European competition agency independent from State Members' interference

Evaluating the magnitude and the stakes of peer effects analysing science and math achievement across OECD

What follows is an exercise aimed at estimating peer effects' impact on science and math test scores of secondary school students surveyed in 1995 by the International Education Agency across OECD countries. It is also to discuss their importance for educational policy, particularly regarding the highly sensitive issue of ability-grouping. Using this unique international database. This study assesses the magnitude of the peer effect relative to more traditional inputs. Referring to education policy stakes, we control for the presence of increasing or decreasing return. This study also checks for cross effects in order to determine whether peer effects matter more to low or high SES pupils, and whether their final impact on achievement is affected by the underlying level of heterogeneity within the group. Using a methodology, which a priori accounts for the clustering of the data within countries and schools/classrooms - i.e. fixed/random effect or hierarchical model - our analysis indicates that peer effects are strong determinants of both math and science achievement relative to individual SES and other school inputs. The presence of increasing of decreasing returns is not obvious. But we find systematic evidence that low-ability pupils are more sensitive to peer group characteristics. By contrast, this study also find that - for a given level of the peer effect - higher heterogeneity comes at a certain cost. In brief, these results provide no systematic evidence regarding grouping policies.