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Leveraging the Multidisciplinary Tumor Board for Dissemination of Evidence-Based Recommendations on the Staging and Treatment of Gastric Cancer: A Pilot Study.
Mehta, Shivani N; Shenvi, Edna C; Blair, Sarah L; Caudle, Abigail; Lowenstein, Lisa M; Kelly, Kaitlyn J.
Afiliação
  • Mehta SN; Department of Surgery, University of California, San Diego, CA, USA.
  • Shenvi EC; Department of Surgery, University of California, San Diego, CA, USA.
  • Blair SL; Department of Surgery, University of California, San Diego, CA, USA.
  • Caudle A; Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Lowenstein LM; Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Kelly KJ; Department of Surgery, University of California, San Diego, CA, USA. Kjkelly3@wisc.edu.
Ann Surg Oncol ; 30(2): 1120-1129, 2023 Feb.
Article em En | MEDLINE | ID: mdl-36222932
ABSTRACT

BACKGROUND:

Compliance with evidence-based treatment guidelines for gastric cancer across the United States is poor. This pilot study aimed to create and evaluate a change package for disseminating information on the staging and treatment of gastric cancer during multidisciplinary tumor boards and for identifying barriers to implementation.

METHODS:

The change package included a 10-min video, a brief knowledge assessment, and a discussion guide. Commission on Cancer-accredited sites that perform gastrectomy were invited to participate. Participants completed the Organizational Readiness for Implementing Change (ORIC) scale (range, 12-60) and scales to measure the feasibility, acceptability, and appropriateness (score range, 4-20). Semi-structured interviews were conducted to further define inner and outer setting barriers.

RESULTS:

Seven centers participated in the study. A total of 74 participants completed the pre-video knowledge assessment, and 55 participants completed the post-video assessment. The recommendations found to be most controversial were separate staging laparoscopy and modified D2 lymphadenectomy. Sum scores were calculated for acceptability (mean, 17.43 ± 2.51) appropriateness (mean, 16.86 ± 3.24), and feasibility (mean, 16.14 ± 3.07) of the change package. The ORIC scores (mean, 46.57 ± 8.22) correlated with responses to the open-ended questions. The key barriers identified were patient volume, skills in the procedures, and attitudes and beliefs.

CONCLUSIONS:

The change package was moderately to highly feasible, appropriate, and acceptable. The activity identified specific recommendations for gastric cancer care that are considered controversial and local barriers to implementation. Future efforts could focus on building skills and knowledge as well as the more difficult issue of attitudes and beliefs.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article