SEMINAR | Jianrong Zhang and Allison Drosdowsky

SEMINAR | Timely diagnosis and treatment for lung cancer: a systematic overview

JIANRONG ZHANG
PhD Candidate
Department of General Practice

Over half of patients with lung cancer are diagnosed at a stage when curative treatment is not possible, suggesting an earlier diagnosis could improve outcomes. This overview summarises the evidence from 18 systematic and scoping reviews that:

1) Times to diagnosis and treatment significantly varied and were often longer than recommended in international guidelines

2) More original studies reported either no or negative association rather than positive association between time intervals and survival or tumour stage

3) Risk factors to times to diagnosis and treatment were considerable, categorized at the disease, patient, healthcare provider and system levels

4) Interventions including fast-access diagnosis programs, patient navigation and multidisciplinary strategies were effective in reducing times to diagnosis and treatment;

5) Methodological issues included large variations in interval definitions and summary measures, lack of addressing an important potential source of bias-the "waiting time paradox"-and few studies of trends over time of these intervals.

Jianrong Zhang is a third-year PhD candidate based at the Department of General Practice & Victorian Comprehensive Cancer Centre (VCCC) Data Driven Research Hub, conducting a transdisciplinary research on the timeliness of lung cancer diagnosis and treatment, including systematic review and data-linkage study of primary & subsequent care and cancer registry.

In 2008–2016, he accomplished medicine degrees at Guangzhou Medical University (China), including clinical & research training in thoracic surgery & oncology at the National Clinical Research Center for Respiratory Disease. In 2017-2019, he studied epidemiology as Master of Public Health candidate & health policy as the Clark-Fox Policy Scholar at Washington University in St. Louis (USA). Since 2020, he started the PhD at the University of Melbourne, supervised by Profs. Jon Emery and Maarten IJzerman.

Along with conducting research, he provides support in different student leadership roles for the Department, Melbourne Medical School, Faculty of MDHS and the University (e.g., chair for the MDHS Graduate Research Conference 2022). His research areas involve thoracic surgery & oncology, primary care, health services research, global health, and study design & methodology.

SEMINAR | Methodological review and meta-analysis of research on the early diagnosis and treatment of colorectal cancer

ALLISON  DROSDOWSKY
PhD Candidate
University of Melbourne

Research focusing on the timeliness of events in the period before diagnosis and initial treatment in colorectal cancer is important for determining how to improve a range of outcomes. Despite the development of design and reporting guidelines, this research area is noted for its heterogeneity, and varied methodological quality, making evidence synthesis difficult. This systematic review was conducted to provide a comprehensive assessment of potential issues in the design and conduct of research in order to improve the evidence base and provide recommendations for future research. Additionally, we assessed the utility of a novel dose-response meta-analytic technique to synthesise findings while allowing for considerations such as non-linear relationships as well as the synthesis of disparate research designs.

Allison Drosdowsky is a Health Services Researcher with ten years experience in a tertiary clinical setting, specialising in the development and execution of statistical analysis plans, and advising on quantitative study design and methodology. She has experience working with large administrative health datasets including cleaning and preparation of data, and statistical analysis, as well as the analysis of clinical trials, patient-reported outcome measures and health program evaluation.