Follow-up evaluation of a web-based pediatric brain tumor board in Latin America
Por:
Rosabal-Obando M, Osorio DS, Lassaletta A, Morales-La Madrid A, Bartels U, Finlay JL, Qaddoumi I, Rutkowski S and Mynarek M
Publicada:
1 sep 2021
Ahead of Print:
1 may 2021
Resumen:
Background Since 2013, pediatric oncologists from Central and South America discuss neuro-oncology cases with experts from North America and Europe in a web-based "Latin American Tumor Board" (LATB). Here, we evaluate the feasibility of recommendations rendered by the Board.
Methods An electronic questionnaire was distributed to physicians who had received recommendations between October 2017 and October 2018. Physicians were asked regarding the feasibility of each recommendation given during the LATB discussion. Baseline case characteristics of all presented cases were obtained from anonymized minutes.
Results Of the 142 patients discussed, data on 103 patients from 15 countries were available, corresponding to 283 recommendations. Physicians followed 60% of diagnostic procedural recommendations and 69% of therapeutic recommendations. The most difficult recommendations to follow were genetic and molecular testing, pathology review, chemotherapy, surgery, and molecular targeted therapies. Histological diagnoses changed in eight of 18 cases in which a pathology review was undertaken. Fifty-four percent of the recommendations that could not be implemented were considered not feasible in the specific context of the patient, while 31% were not implemented due to a decision of the medical staff or the parents (15% not specified). However, 96% of respondents considered the recommendations useful.
Conclusion Recommendations were frequently perceived as useful, and were applicable in the participating institutions. Nevertheless, limitations in availability of diagnostic procedures and treatment modalities affected the feasibility of some recommendations. Tele-oncology tumor boards offer physicians from low- and middle-income countries access to real-time, high-level subspecialist expertise and provide a valuable platform for worldwide information exchange.
Filiaciones:
Rosabal-Obando M:
Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Osorio DS:
Neuro-Oncology Program, Division of Hematology, Oncology and BMT, Nationwide Children's Hospital, Ohio State University, Columbus, Ohio, USA
Lassaletta A:
Pediatric Oncology, Hematology and Stem Cell Transplant Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
Morales-La Madrid A:
Department of Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Bartels U:
Neuro-Oncology, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
Finlay JL:
Neuro-Oncology Program, Division of Hematology, Oncology and BMT, Nationwide Children's Hospital, Ohio State University, Columbus, Ohio, USA
Qaddoumi I:
Global Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
Rutkowski S:
Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Mynarek M:
Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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