Cancer Diagnosis, Disabled Persons
Conditions
Brief summary
The MICaDO study is a multi-method study that aims to investigate inclusive cancer diagnosis in people with disabilities and health outcomes. The main objective is to examine variations in cancer diagnosis and outcomes among individuals with psychiatric, intellectual, neurological, and sensory disabilities to develop interventions aimed at improving cancer care. The hypothesis that investigators will investigate is that people with disability are diagnosed with cancer later than people without disability due to a range of barriers, including physical, sensory, cognitive, and social barriers. The study will use a mixed-methods approach, combining quantitative research (electronic health record analysis) and qualitative research (interviews). The total duration of the study is two years.
Interventions
OTHERNot applicable- observational study
Not applicable - observational study
Sponsors
Politecnico di Milano
University College, London
Accademia Lombarda di Sanità Pubblica
DAMA (Disabled Advanced Medical Assistance)
LEDHA (League for the Rights of People with Disabilities and the Promotion of Autonomy)
HPA (Health Protection Agency) of the Metropolitan City of Milan
Cristina Renzi
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Electronic health record study: * Patients with psychiatric, intellectual, neurological, and sensory disabilities who received care at San Raffaele Hospital of Milan between 2011 and 2024 * Patients without disabilities who received care at San Raffaele Hospital of Milan between 2011 and 2024 (ratio 4:1 of patients without vs. with disabilities) * Patients with psychiatric, intellectual, neurological, and sensory disabilities recorded in the Lombardy Regional Data Warehouse between 2011 and 2024 * Patients without disabilities recorded in the Lombardy Regional Data Warehouse between 2011 and 2024 (ratio 4:1 of patients without vs. with disabilities) * Patients aged 18 and over Qualitative Interviews: * Patients aged 18 and over with psychiatric, intellectual, neurological, and sensory disabilities who received care at San Raffaele Hospital of Milan, DAMA (Disabled Advanced Medical Assistance) in Territorial Social Health Companies Santi Paolo e Carlo and LEDHA (League for the Rights of People with Disabilities and the Promotion of Autonomy) and their caregivers * Healthcare provider working at San Raffaele Hospital of Milan, DAMA (Disabled Advanced Medical Assistance) in Territorial Social Health Companies Santi Paolo e Carlo and general practitioners
Exclusion criteria
* Patients under 18 years of age * Patients don't speak the Italian language (for the qualitative study)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic pathways and oncological outcomes in Patients with Disabilities: | Baseline | For the quantitative part of the study, the investigators will examine several outcomes, each measured separately comparing patients with and without specific disabilities: emergency presentation measured as a binary variable (No/Yes); diagnosis through screening measured as a binary variable (No/Yes); cancer stage at diagnosis measured as an ordinal categorical variable (Stage 1, 2, 3, 4); short-term mortality measured as a percentage rate at 30 days and 90 days from diagnosis. The data will be extracted from electronic health records at San Raffaele Hospital in Milan and the Lombardy Regional Data Warehouse. For the qualitative part of the study, the investigators will perform qualitative interviews with patients/caregivers and healthcare providers from the Lombardy Region. Patients with various types of disabilities will be recruited at the San Raffaele Hospital in Milan and through outreach activities by LEDHA and DAMA. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Accessibility and inclusiveness in Diagnostic Services: Validation of the DfA A.U.D.I.T. | Baseline | The investigators will employ the Design for All (DfA) A.U.D.I.T., a digital platform developed by the Design and Health Lab of the Politecnico di Milano, to examine building performance, focusing on screening and diagnostic services. Specifically, the investigators will evaluate the interaction between physical, sensory, cognitive, and social barriers to validate a DfA tool for improving accessibility, inclusivity, and equity. |
Outcome results
None listed