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多学科肿瘤委员会就诊患者临床试验入组的回顾性分析及相关障碍。

A Retrospective Analysis of Clinical Trial Accrual of Patients Presented in a Multidisciplinary Tumor Board at a Tertiary Health Care Center and Associated Barriers.

机构信息

Center for Young Adult Cancer Survivorship, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.

出版信息

Oncol Res Treat. 2020;43(5):196-203. doi: 10.1159/000506840. Epub 2020 Mar 27.

Abstract

INTRODUCTION

Cancer clinical trial accruals have been historically low and are affected by several factors. Multidisciplinary Tumor Board Meetings (MTBM) are conducted regularly and immensely help to devise a comprehensive care plan including discussions about clinical trial availability and eligibility.

OBJECTIVES

To evaluate whether patient discussion at MTBM was associated with a higher consent rate for clinical trials at a single tertiary care center.

METHODS

Institutional electronic medical records (EMR) and clinical trials management system (OnCore) were queried to identify all new patient visits in oncology clinics, consents to clinical trials, and MTBM notes between January 1, 2011 and December 31, 2015. The association between MTBM discussion and subsequent clinical trial enrollment within 16 weeks of the new patient visit was evaluated using a χ2 test.

RESULTS

Between January 1, 2011 and December 31, 2015, 11,794 new patients were seen in oncology clinics, and 2,225 patients (18.9%) were discussed at MTBMs. MTBM discussion conferred a higher rate of subsequent clinical trial consent within 16 weeks following the patient's first consultation in an oncology clinic: 4.1% for those who were discussed at a MTBM compared to 2.8% for those not discussed (p < 0.01).

CONCLUSIONS

This study provides evidence that MTBMs may be effective in identifying patients eligible for available clinical trials by reviewing eligibility criteria during MTBM discussions. We recommend discussion of all new patients in MTBM to improve the quality of care provided to those with cancer and enhanced clinical trial accrual.

摘要

简介

癌症临床试验的入组率一直很低,受到多种因素的影响。多学科肿瘤委员会会议(MTBM)定期举行,对于制定全面的治疗计划非常有帮助,包括讨论临床试验的可及性和资格。

目的

评估在 MTBM 上对患者的讨论是否与单一三级护理中心的临床试验更高的同意率相关。

方法

查询机构电子病历(EMR)和临床试验管理系统(OnCore),以确定在肿瘤学诊所的所有新患者就诊、临床试验同意书和 2011 年 1 月 1 日至 2015 年 12 月 31 日之间的 MTBM 记录。使用 χ2 检验评估 MTBM 讨论与新患者就诊后 16 周内后续临床试验入组之间的关联。

结果

在 2011 年 1 月 1 日至 2015 年 12 月 31 日期间,在肿瘤学诊所就诊的新患者为 11794 例,在 MTBM 中讨论的患者为 2225 例(18.9%)。MTBM 讨论使随后在肿瘤学诊所首次就诊后 16 周内进行临床试验的同意率更高:在 MTBM 中讨论的患者中,有 4.1%的患者同意,而未讨论的患者中,有 2.8%的患者同意(p<0.01)。

结论

这项研究提供了证据,表明 MTBM 可以通过在 MTBM 讨论期间审查资格标准,有效识别有资格参加现有临床试验的患者。我们建议在 MTBM 中讨论所有新患者,以提高对癌症患者的护理质量并增加临床试验的入组率。

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