Any trial will probably have to test different levels or intensities of care planning. In this case, large sample sizes will be necessary to detect differences between groups.

In conclusion, rigorous systematic studies are necessary in order to determine what works and what does not work in survivorship care planning. The IOM report called for increased support for research and demonstration projects. The goal is to have good evidence on which to base guidelines and standards of care and thereby improve care delivery and optimize the health of survivors.

Discussion

Dr. Raich of Denver Health Medical Center suggested that multiinstitutional, interdisciplinary collaborations will be needed to strengthen the capacity to address the many research questions raised by Dr. Earle. Dr. Earle agreed that a large collaborative venture was probably needed to address the many challenges posed by this research. He noted, however, that such collaborative networks were difficult to organize and fund. Dr. Smita Bhatia of City of Hope Comprehensive Cancer Center emphasized the need to learn from the experience of the pediatric oncology community, which has organized a team effort to create care summaries and guidelines.



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