Palliative Radiation Oncology Program and Princess Margaret Hospital, University Health Network, University of Toronto, Canada.
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):e167-72. doi: 10.1016/j.ijrobp.2012.03.057. Epub 2012 Jun 8.
The purpose of this study was to assess the accuracy of a virtual consultation (VC) process in determining treatment strategy for patients with malignant epidural spinal cord compression (MESCC).
A prospective clinical database was maintained for patients with MESCC. A virtual consultation process (involving exchange of key predetermined clinical information and diagnostic imaging) facilitated rapid decision-making between oncologists and spinal surgeons. Diagnostic imaging was reviewed retrospectively (by R.R.) for surgical opinions in all patients. The primary outcome was the accuracy of virtual consultation opinion in predicting the final treatment recommendation.
After excluding 20 patients who were referred directly to the spinal surgeon, 125 patients were eligible for virtual consultation. Of the 46 patients who had a VC, surgery was recommended in 28 patients and actually given to 23. A retrospective review revealed that 5/79 patients who did not have a VC would have been considered surgical candidates. The overall accuracy of the virtual consultation process was estimated at 92%.
The VC process for MESCC patients provides a reliable means of arriving at a multidisciplinary opinion while minimizing patient transfer. This can potentially shorten treatment decision time and enhance clinical outcomes.
本研究旨在评估虚拟咨询（VC）过程在确定恶性硬膜外脊髓压迫症（MESCC）患者治疗策略方面的准确性。
为 MESCC 患者建立了前瞻性临床数据库。虚拟咨询过程（涉及关键预定临床信息和诊断影像学的交换）促进了肿瘤学家和脊柱外科医生之间的快速决策。对所有患者的手术意见进行了回顾性诊断影像学检查（由 RR 进行）。主要结果是虚拟咨询意见预测最终治疗建议的准确性。
排除直接转介给脊柱外科医生的 20 名患者后，有 125 名患者符合虚拟咨询条件。在 46 名接受 VC 的患者中，28 名患者建议手术，实际进行了 23 例。回顾性研究显示，79 名未进行 VC 的患者中有 5 名将被视为手术候选者。虚拟咨询过程的总体准确性估计为 92%。
MESCC 患者的 VC 流程提供了一种可靠的多学科意见达成方式，同时最大限度地减少了患者转移。这可能会缩短治疗决策时间并改善临床结果。
