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Simple Summary: This study looks at how combining real-world/time data/evidence (RWTD/E) with traditional clinical studies (known as randomized controlled trials) can improve healthcare research and ultimately patient care. Unlike past methods that often rely on outdated information, RWTD/E provides up-to-the-minute data on patient health, making it a powerful tool for doctors and researchers. This approach is especially useful in areas like sarcoma, a type of cancer, where understanding each patient's unique situation can lead to improved treatment plans. We discuss how this mix of real-world/time data and traditional research can lead to more personalized medicine, helping to create treatments tailored to individual patient needs. It also aids in managing health at a community level by spotting trends and improving health policies, making care more efficient and focused on what patients truly benefit from. Furthermore, we explore how applying new methods, like creating digital twins of patients' health profiles to RWTD/E can help in predicting individualized treatment effects. This study aims to elaborate that using prospective RWTD/E alongside traditional clinical trials can make healthcare more effective, patient-focused, and ready to adapt to new discoveries and technologies. This manuscript examines the synergistic potential of prospective real-world/time data/evidence (RWTD/E) and randomized controlled trials (RCTs) to enrich healthcare research and operational insights, with a particular focus on its impact within the sarcoma field. Through exploring RWTD/E's capability to provide real-world/time, granular patient data, it offers an enriched perspective on healthcare outcomes and delivery, notably in the complex arena of sarcoma care. Highlighting the complementarity between RWTD/E's expansive real-world/time scope and the structured environment of RCTs, this paper showcases their combined strength, which can help to foster advancements in personalized medicine and population health management, exemplified through the lens of sarcoma treatment. The manuscript further outlines methodological innovations such as target trial emulation and their significance in enhancing the precision and applicability of RWTD/E, underscoring the transformative potential of these advancements in sarcoma care and beyond. By advocating for the strategic incorporation of prospective RWTD/E into healthcare frameworks, it aims to create an evidence-driven ecosystem that significantly improves patient outcomes and healthcare efficiency, with sarcoma care serving as a pivotal domain for these developments. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we aimed to understand the association between two types of surgeries on sarcoma outcomes: surgeries that were planned with a clear understanding of the cancer (planned resections) and those that were performed unexpectedly, without prior knowledge that the tumor was cancerous (unplanned resections). Using the novel Target Trial Emulation framework, we assessed how these surgeries impact local recurrence-free survival, metastasis-free survival, cancer-specific survival, and overall survival. Our study found that patients who had unplanned surgeries were more likely to experience their cancer recur at the surgery site. However, there was not a substantial difference in how long patients survived after either type of surgery. Our findings highlight the importance of immediately referring patients to specialized sarcoma treatment centers where unplanned resections are less likely to occur to improve treatment outcomes and provide evidence to guide better management strategies for sarcoma. This study follows the Target Trial Emulation (TTE) framework to assess the impact of unplanned resections (UEs) and planned resections (PEs) of sarcomas on local recurrence-free survival (LRFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). Sarcomas, malignant tumors with mesenchymal differentiation, present a significant clinical challenge due to their rarity, complexity, and the frequent occurrence of UEs, which complicates effective management. Our analysis utilized real-world-time data from the Swiss Sarcoma Network, encompassing 429 patients, to compare the impact of UEs and PEs, adjusting for known prognostic factors through a multivariable Cox regression model and propensity score weighting. Our findings reveal a significantly higher risk of local recurrence for UEs and a short-term follow-up period that showed no marked differences in MFS, CSS, and OS between the UE and PE groups, underlining the importance of optimal initial surgical management. Furthermore, tumor grade was validated as a critical prognostic factor, influencing outcomes irrespective of surgical strategy. This study illuminates the need for improved referral systems to specialized sarcoma networks to prevent UEs and advocates for the integration of TTE in sarcoma research to enhance clinical guidelines and decision-making in sarcoma care. Future research should focus on the prospective validations of these findings and the exploration of integrated care models to reduce the incidence of UEs and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcomas are rare cancers that are complex to treat and can be expensive to manage, especially when considering surgery costs. This research investigates how much sarcoma surgeries cost across three different hospitals in Switzerland and examines what factors might cause these costs to vary. By consistently using the same surgeon for all procedures, the study ensures that differences in surgical expertise do not affect the results, allowing a clear focus on hospital practices and the complexity of tumor impact costs. The findings aim to help hospitals better plan and manage resources, potentially leading to more cost-effective treatments. This study could influence how healthcare systems approach the financial aspects of treating complex cancers, encouraging a shift towards more standardized and economically sustainable practices. Background: Sarcomas present a unique challenge within healthcare systems due to their rarity and complex treatment requirements. This study explores the economic impact of sarcoma surgeries across three Swiss tertiary healthcare institutions, utilizing a consistent surgical approach by a single surgeon to eliminate variability in surgical expertise as a confounding factor. Methods: By analyzing data from 356 surgeries recorded in a real-world-time data warehouse, this study assesses surgical and hospital costs relative to institutional characteristics and surgical complexity. Results: Our findings reveal significant cost variations driven more by institutional resource management and pricing strategies than by surgical techniques. Surgical and total hospitalization costs were analyzed in relation to tumor dignity and complexity scores, showing that higher complexity and malignancy significantly increase costs. Interestingly, it was found that surgical costs accounted for only one-third of the total hospitalization costs, highlighting the substantial impact of non-surgical factors on the overall cost of care. Conclusions: The study underscores the need for standardized cost assessment practices and highlights the potential of predictive models in enhancing resource allocation and surgical planning. By advocating for value-based healthcare models and standardized treatment guidelines, this research contributes to more equitable and sustainable healthcare delivery for sarcoma patients. These insights affirm the necessity of including a full spectrum of care costs in value-based models to truly optimize healthcare delivery. These insights prompt a reevaluation of current policies and encourage further research across diverse geographical settings to refine cost management strategies in sarcoma treatment. [ABSTRACT FROM AUTHOR]

The landscape of sarcoma care is on the cusp of a transformative era, spurred by the convergence of digital health and artificial intelligence (AI). This perspectives article explores the multifaceted opportunities and challenges in leveraging these technologies for value-based, precision sarcoma care. We delineate the current state-of-the-art methodologies and technologies in sarcoma care and outline their practical implications for healthcare providers, administrators, and policymakers. The article also addresses the limitations of AI and digital health platforms, emphasizing the need for high-quality data and ethical considerations. We delineate the promise held by the synergy of digital health platforms and AI algorithms in enhancing data-driven decision-making, outcome analytics, and personalized treatment planning. The concept of a sarcoma digital twin serves as an illustrative paradigm for this integration, offering a comprehensive, patient-centric view of the healthcare journey. The paper concludes with proposals for future research aimed at advancing the field, including the need for randomized controlled trials or target trial emulations and studies focusing on ethical and economic aspects. While the road to this transformative care is laden with ethical, regulatory, and practical challenges, we believe that the potential benefits far outweigh the obstacles. We conclude with a call to action for multidisciplinary collaboration and systemic adoption of these technologies, underscoring the urgency to act now for the future betterment of sarcoma care and healthcare at large. [ABSTRACT FROM AUTHOR]

Simple Summary: Benchmarking is a crucial tool for healthcare providers to improve quality and efficiency, especially for complex conditions like sarcomas. Sarcomas are a type of cancer that require a multidisciplinary approach to treatment. However, despite adherence to international guidelines, differences in the processes used by these boards can affect patient outcomes and treatment costs. This study compared two multidisciplinary teams/sarcoma tumor boards and established an interoperable digital platform, Sarconnector®, for real-world time (RWT) data assessment and automated analysis. Differences were obtained in various areas, such as first-time presentations, follow-up presentations, primary sarcomas, biopsies and chemotherapy indications. By identifying areas of improvement and making data-driven decisions on the meta-level, healthcare providers can optimize resources and improve patient outcomes. Benchmarking with the RWT harmonized data approach provided by the Sarconnector® can help healthcare providers achieve better outcomes for their patients and improve the overall effectiveness of the healthcare system. Benchmarking is crucial for healthcare providers to enhance quality and efficiency, notably for complex conditions like sarcomas. Multidisciplinary teams/sarcoma boards (MDT/SBs) are vital in sarcoma management, but differences in their processes can affect patient outcomes and treatment costs, despite adherence to international guidelines. To address this issue, this study aimed to compare two MDT/SBs and establish an interoperable digital platform, Sarconnector®, for real-time-world data assessment and automated analysis. The study included 983 patients, 46.0% of whom female, with a median age of 58 years, and 4.5% of patients presented with metastasis at diagnosis. Differences were observed in the number of first-time presentations, follow-up presentations, primary sarcomas, biopsies and chemotherapy indications between the two MDT/SB. The results highlight the importance of benchmarking and utilizing a harmonized data approach, such as the RWT approach provided by the Sarconnector®, to standardize and evaluate quality and cost metrics. By identifying areas of improvement and making data-driven decisions on the meta-level, healthcare providers can optimize resources and improve patient outcomes. In conclusion, benchmarking with the RWT harmonized data approach provided by the Sarconnector® can help healthcare providers improve the overall effectiveness of the healthcare system and achieve better outcomes for their patients in terms of both outcomes and costs. [ABSTRACT FROM AUTHOR]

Simple Summary: This article comprehensively defines, assesses and analyzes quality indicators of sarcoma care. A novel interoperable digital platform is presented that gathers information from physicians (work-up, therapy and MDT information) as well as patients (PROMS/PREMS) consecutively and instantly when a new event occurs, which thereby automatically provides evidence of the quality of care on all aspects. As the platform analyzes annotated real-time world information, predictive modelling and value-based health care may become a reality, thereby giving rise to precision health care in the future. Sarcomas represent a large group of rare to very rare diseases, requiring complex management with a transdisciplinary approach. Overall progress has been hampered because of discipline, institution and network fragmentation, and there is no global data harmonization or quality standards. To report on and improve quality, a common definition of quality indicators (QIs) of sarcoma care as well as the capacity to assess longitudinal real-time data is required. An international advisory board of world-renowned sarcoma experts defined six categories of QIs, totaling more than 80 quality indicators. An interoperable (web-based) digital platform was then created combining the management of the weekly sarcoma board meeting with the sarcoma registry and incorporating patient-reported outcome measures (PROMs) into the routine follow-up care to assess the entire care cycle of the patient. The QIs were then programmed into the digital platform for real-time analysis and visualization. The definition of standardized QIs covering all physician- (diagnostics and therapeutics), patient- (PROMS/PREMS), and cost-based aspects in combination with their real-time assessment over the entire sarcoma care cycle can be realized. Standardized QIs as well as their real-time assessment and data visualization are critical to improving the quality of sarcoma care. By enabling predictive modelling and introducing VBHC, precision health care for a complex disease is on the horizon. [ABSTRACT FROM AUTHOR]