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肺癌肿瘤委员会建议的遵循情况及向临床实践的转化。

Guideline adherence of tumor board recommendations in lung cancer and transfer into clinical practice.

机构信息

Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany.

German Center for Lung Research (DZL), Giessen, Germany.

出版信息

J Cancer Res Clin Oncol. 2023 Oct;149(13):11679-11688. doi: 10.1007/s00432-023-05025-1. Epub 2023 Jul 5.

Abstract

PURPOSE

Evaluating patients and treatment decisions in a multidisciplinary tumor board has led to better quality of care and longer survival in cancer patients. The aim of this study was to evaluate tumor board recommendations for thoracic oncology patients regarding guideline adherence and transferal of recommendations into clinical practice.

METHODS

We evaluated tumor board recommendations of the thoracic oncology tumor board at Ludwig-Maximilians University (LMU) Hospital Munich between 2014 and 2016. We compared patient characteristics between guideline-adherent and non-guideline-adherent recommendations, as well as between transferred and non-transferred recommendations. We used multivariate logistic regression models to evaluate factors associated with guideline adherence.

RESULTS

Over 90% of recommendations by the tumor board were either adherent to the guidelines (75.5%) or over fulfilling guidelines (15.6%). Almost 90% of recommendations were transferred to clinical practice. If a recommendation was not according to the guidelines, the reason was mostly associated with the general condition (age, Charlson comorbidity index, ECOG) of the patient or due to the patients' request. Surprisingly, sex also had a significant influence on the guideline adherence of recommendations, with females being more likely to get recommendations not according to the guidelines.

CONCLUSION

In conclusion, the results of this study are promising, as the guideline adherence of recommendations as well as the transferal of recommendations into clinical practice were high. In the future, a special focus should be put on fragile patients as well as female patients.

摘要

目的

在多学科肿瘤委员会中评估患者和治疗决策,已导致癌症患者的护理质量提高和生存时间延长。本研究的目的是评估胸肿瘤学肿瘤委员会对胸肿瘤学肿瘤委员会的建议,以评估其对指南的遵守情况以及将建议转化为临床实践的情况。

方法

我们评估了 2014 年至 2016 年期间慕尼黑路德维希-马克西米利安大学医院胸肿瘤学肿瘤委员会的肿瘤委员会建议。我们比较了指南遵守建议和非指南遵守建议之间以及转移建议和非转移建议之间的患者特征。我们使用多变量逻辑回归模型来评估与指南遵守相关的因素。

结果

肿瘤委员会的建议中,超过 90%是符合指南的(75.5%)或过度符合指南的(15.6%)。几乎 90%的建议都被转移到了临床实践中。如果建议不符合指南,原因通常与患者的一般状况(年龄、Charlson 合并症指数、ECOG)或患者的要求有关。令人惊讶的是,性别对建议的指南遵守也有显著影响,女性更有可能获得不符合指南的建议。

结论

总之,这项研究的结果是有希望的,因为建议的指南遵守率以及建议向临床实践的转移率都很高。在未来,应特别关注脆弱患者和女性患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316b/11796521/208e9d6b2623/432_2023_5025_Fig1_HTML.jpg

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