Kostaras Xanthoula, Shea-Budgell Melissa A, Malcolm Emily, Easaw Jacob C, Roa Wilson, Hagen Neil A
Guideline Utilization Resource Unit, Alberta Health Services-Cancer Care, Calgary, AB, Canada.
J Cancer Educ. 2012 Mar;27(1):42-5. doi: 10.1007/s13187-011-0263-6.
The aim of this study was to characterize practice patterns and decision-making processes of healthcare providers attending weekly neuro-oncology tumor board meetings, and to assess their familiarity with clinical practice guidelines (CPGs) in neuro-oncology. Members of the Neuro-Oncology Tumor Team at two tertiary cancer centers completed a web-based questionnaire assessing characteristics of weekly tumor board meetings and perceptions of CPGs. Twenty-three (66%) tumor team members responded. Diagnostic imaging results and interpretation, medical, surgical, and/or radiation treatment planning, and pathology results and interpretation were the most commonly identified aspects of patient care discussed at tumor board meetings, and almost all respondents indicated that these meetings were "very beneficial" to their own practice. When deciding on a treatment plan, respondents rely most on the clinical expertise of colleagues, medical literature, personal experience, active clinical trial protocols, and published CPGs. Opinions of the local CPGs varied considerably, and while 56% of respondents supported regular discussion of them during meetings, only 32% indicated that they were routinely reviewed. Updating the literature more frequently, implementing a formal grading system for the evidence, and incorporating clinical care pathways were the most frequently cited methods to improve the CPGs. Tumor board meetings are beneficial to the treatment planning process for neuro-oncology patients.
本研究的目的是描述参加每周神经肿瘤学肿瘤病例讨论会的医疗服务提供者的实践模式和决策过程,并评估他们对神经肿瘤学临床实践指南(CPG)的熟悉程度。两家三级癌症中心的神经肿瘤学肿瘤团队成员完成了一份基于网络的问卷,评估每周肿瘤病例讨论会的特点以及对CPG的看法。23名(66%)肿瘤团队成员做出了回应。诊断成像结果及解读、医疗、手术和/或放射治疗计划,以及病理结果及解读是肿瘤病例讨论会上最常讨论的患者护理方面,几乎所有受访者都表示这些会议对他们自己的实践“非常有益”。在决定治疗方案时,受访者最依赖同事的临床专业知识、医学文献、个人经验、现行临床试验方案和已发表的CPG。对当地CPG的看法差异很大,虽然56%的受访者支持在会议期间定期讨论CPG,但只有32%的受访者表示会定期查阅。更频繁地更新文献、实施正式的证据分级系统以及纳入临床护理路径是最常被提及的改进CPG的方法。肿瘤病例讨论会对神经肿瘤学患者的治疗计划过程有益。