Impact of a Virtual Multidisciplinary Sarcoma Case Conference on Treatment Plan and Survival in a Large Integrated Healthcare System

Pan, Minggui; Yu, Jack; Sidhu, M.; Seto, Tiffany; Fang, Andrew

doi:10.1200/op.20.01078

Cited by 7 publications

(6 citation statements)

References 20 publications

(30 reference statements)

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“… 9 Virtual MTBs have been adapted by various specialties evaluating lung cancer, breast cancer, gastrointestinal cancers, lymphoma, and head, and neck cancer. 8 , 9 , 10 , 11 , 12 , 13 The virtual MTB plays an important role in changing management. A study of the multidisciplinary lymphoma virtual tumor board demonstrated changes in radiologic interpretation (1.9%), pathologic diagnosis (9.4%), and clinical management (30%).…”

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confidence: 99%

“…A 6‐month survey of participants in the lung cancer virtual MTB found that 95% believed the virtual MTB to be feasible and acceptable as well as impactful with regards to optimizing the flow of clinical information (91%), equity of care (96%) and specialist collaboration (88%) 9 . Virtual MTBs have been adapted by various specialties evaluating lung cancer, breast cancer, gastrointestinal cancers, lymphoma, and head, and neck cancer 8‐13 . The virtual MTB plays an important role in changing management.…”

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confidence: 99%

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Regionalization of Head and Neck Oncology Tumor Boards: Perspectives of Collaborating Physicians

et al. 2023

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Objectives To survey academic and community physician preferences regarding the virtual multidisciplinary tumor board (MTB) for further improvement and expansion. Study Design This anonymous 14‐question survey was sent to individuals that participated in the head and neck virtual MTBs. The survey was sent via email beginning August 3, 2021, through October 5, 2021. Setting The University of Maryland Medical Center and regional practices in the state of Maryland. Methods Survey responses were recorded and presented as percentages. Subset analysis was performed to obtain frequency distributions by facility and provider type. Results There were 50 survey responses obtained with a response rate of 56%. Survey participants included 11 surgeons (22%), 19 radiation oncologists (38%), and 8 medical oncologists (16%), amongst others. More than 96% of participants found the virtual MTB to be useful when discussing complex cases and impactful to future patient care. A majority of respondents perceived a reduction in time to adjuvant care (64%). Community and academic physician responses strongly agreed that the virtual MTB improved communication (82% vs 73%), provided patient‐specific information for cancer care (82% vs 73%), and improved access to other specialties (66% vs 64%). Academic physicians, more so than community physicians, strongly agreed that the virtual MTB improves access to clinical trial enrollment (64% vs 29%) and can be useful in obtaining CME (64% vs 55%). Conclusion Academic and community physicians view the virtual MTB favorably. This platform can be adapted regionally and further expanded to improve communication between physicians and improve multidisciplinary care for patients.

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confidence: 99%

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confidence: 99%

Regionalization of Head and Neck Oncology Tumor Boards: Perspectives of Collaborating Physicians

et al. 2023

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“…As a positive outcome of the COVID-19 pandemic, telehealth has made virtual collaboration more attainable than ever, allowing the expansions of existing medical networks via online communication. In previous studies of sarcoma MTBs that moved to an online platform as a result of the pandemic, there was no perceived difference in quality of discussion compared to in-person meetings [ 31 ], while also having no measurable effect on overall survival [ 32 ]. The potential impact of utilizing technology to create virtual MTBs, which connect single-institution or single-network MTBs into one large MTB, could change our entire existing framework of sarcoma care.…”

Section: Discussionmentioning

confidence: 99%

The Midwest Sarcoma Trials Partnership: Bridging Academic and Community Networks in a Collaborative Approach to Sarcoma

Heater

Okuno

Robinson

et al. 2023

JCM

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The treatment of sarcoma necessitates a collaborative approach, given its rarity and complex management. At a single institution, multidisciplinary teams of specialists determine and execute treatment plans involving surgical, radiation, and medical management. Treatment guidelines for systemic therapies in advanced or nonresectable soft tissue sarcoma have advanced in recent years as new immunotherapies and targeted therapies become available. Collaboration between institutions is necessary to facilitate accrual to clinical trials. Here, we describe the success of the Midwest Sarcoma Trials Partnership (MWSTP) in creating a network encompassing large academic centers and local community sites. We propose a new model utilizing online platforms to expand the reach of clinical expertise for the treatment of advanced soft tissue sarcoma.

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“…As one option with some similarities to AccessHope, Meyer et al 10 describe their experience with an asynchronous patient-initiated second opinion service (Best Doctors) covering all aspects of medicine that included 588 patients with hematology or oncology diagnoses, with opinions in this subset estimated to have moderate or major clinical impact in 38% of cases. Another option that provides a multidisciplinary approach is virtual tumor boards or case conferences, which have been pursued for testicular cancer, 11 sarcoma, 12 and lung cancer, 13 with success in improving care while overcoming geographic barriers.…”

Section: Discussionmentioning

confidence: 99%

Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

West

Tan

Barzi

et al. 2022

JCO Oncology Practice

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PURPOSE: AccessHope is a program developed initially by City of Hope to provide remote subspecialist input on cancer care for patients as a supplemental benefit for specific payers or employers. The leading platform for this work has been an asynchronous model of review of medical records followed by a detailed assessment of past and current management along with discussion of potential future options in a report sent to the local oncologist. This summary describes an early period of development and growth of this service, focusing on cases of lung cancer, particularly during the COVID-19 pandemic. METHODS: Cases were primarily identified by a trigger list of cancer diagnoses that included non–small-cell lung cancer and small-cell lung cancer. After medical records were obtained, a summary narrative was provided to a thoracic oncology specialist who wrote a case review sent to the local physician, followed by a direct discussion with the recipient. We focused on feasibility as measured by case volumes, the rates of concordance between the subspecialist reviewer with the local team, and cost savings from recommended changes, using descriptive statistics. RESULTS: From April 2019 to November 2020, 110 cases were reviewed: 55% male, median age 62.5 years (range, 33-92 years); 82% non–small-cell lung cancer (12% stage I or II, 16% stage III, and 57% stage IV), and 17% small-cell lung cancer (4% limited and 14% extensive). Median turnaround time for report send-out was 5.0 days. The review agreed with local management in 79 (72%) cases and disagreed in 31 (28%) cases; notably, specific additional recommendations were associated with evidence-based anticipated improvements in efficacy in 76 cases (69%) and improvement in potential for cure in 14 cases (13%). Recommendations leading to cost savings were identified in 14 cases (13%), translating to a projected cost savings of $19,062 (USD) per patient for the entire cohort of patient cases reviewed. CONCLUSION: We demonstrate the feasibility of completing a rapid turnaround of cases of lung cancer either patient-initiated for review or prospectively triggered by diagnosis and stage. This program of asynchronous second opinions identified evidence-based management changes affecting current treatment in 28% and potential improvements to improve care in 92% of patients, along with cost savings realized by eliminating low-value interventions.

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Impact of a Virtual Multidisciplinary Sarcoma Case Conference on Treatment Plan and Survival in a Large Integrated Healthcare System

Cited by 7 publications

References 20 publications

Regionalization of Head and Neck Oncology Tumor Boards: Perspectives of Collaborating Physicians

Regionalization of Head and Neck Oncology Tumor Boards: Perspectives of Collaborating Physicians

The Midwest Sarcoma Trials Partnership: Bridging Academic and Community Networks in a Collaborative Approach to Sarcoma

Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

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