Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Fam Cancer. 2023 Jan;22(1):1-11. doi: 10.1007/s10689-022-00294-0. Epub 2022 May 16.
Universal tumor DNA testing in epithelial ovarian cancer patients can function not only as an efficient prescreen for hereditary cancer testing, but may also guide treatment choices. This innovation, introduced as Tumor-First workflow, offers great opportunities, but ensuring optimal multidisciplinary collaboration is a challenge. We investigated factors that were relevant and important for large-scale implementation. In three multidisciplinary online focus groups, healthcare professionals (gynecologic oncologists, pathologists, clinical geneticists, and clinical laboratory specialists) were interviewed on factors critical for the implementation of the Tumor-First workflow. Recordings were transcribed for analysis in Atlas.ti according to the framework of Flottorp that categorizes seven implementation domains. Healthcare professionals from all disciplines endorse implementation of the Tumor-First workflow, but more detailed standardization and advice regarding the logistics of the workflow were needed. Healthcare professionals explored ways to stay informed about the different phases of the workflow and the results. They emphasized the importance of including all epithelial ovarian cancer patients in the workflow and monitoring this inclusion. Overall, healthcare professionals would appreciate supporting material for the implementation of the Tumor-First workflow in the daily work routine. Focus group discussions have revealed factors for developing a tailored implementation strategy for the Tumor-First workflow in order to optimize care for epithelial ovarian cancer patients. Future innovations affecting multidisciplinary oncology teams including clinical geneticists can benefit from the lessons learned.
在卵巢上皮癌患者中进行通用肿瘤 DNA 检测，不仅可以作为遗传性癌症检测的有效预筛，还可能指导治疗选择。这种作为“先肿瘤后基因”工作流程引入的创新带来了巨大的机会，但确保多学科之间的最佳合作是一项挑战。我们研究了与大规模实施相关且重要的因素。在三个多学科在线焦点小组中，对医疗保健专业人员（妇科肿瘤学家、病理学家、临床遗传学家和临床实验室专家）进行了关于“先肿瘤后基因”工作流程实施的关键因素的访谈。根据 Flottorp 框架对录音进行了转录，该框架将七个实施领域进行了分类。所有学科的医疗保健专业人员都支持实施“先肿瘤后基因”工作流程，但需要更详细的标准化和有关工作流程后勤的建议。医疗保健专业人员探讨了保持了解工作流程不同阶段和结果的方法。他们强调了将所有卵巢上皮癌患者纳入工作流程并监测纳入情况的重要性。总的来说，医疗保健专业人员将欣赏在日常工作中为实施“先肿瘤后基因”工作流程提供支持材料。焦点小组讨论揭示了为“先肿瘤后基因”工作流程制定定制实施策略的因素，以优化卵巢上皮癌患者的护理。未来影响包括临床遗传学家在内的多学科肿瘤团队的创新可以从这些经验中受益。
