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Influence of endocrine multidisciplinary tumor board on patient management and treatment decision making

  • Author Footnotes
    1 Both authors contributed equally to this manuscript and are co-first authors.
    Sarah Kelley
    Footnotes
    1 Both authors contributed equally to this manuscript and are co-first authors.
    Affiliations
    University of Iowa Hospitals and Clinics, Department of Internal Medicine, 200 Hawkins Dr, Iowa City, IA, 52242, USA
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  • Author Footnotes
    1 Both authors contributed equally to this manuscript and are co-first authors.
    Anna C. Beck
    Footnotes
    1 Both authors contributed equally to this manuscript and are co-first authors.
    Affiliations
    University of Iowa Hospitals and Clinics, Department of Surgery, 200 Hawkins Dr, Iowa City, IA, 52242, USA
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  • Ronald J. Weigel
    Affiliations
    University of Iowa Hospitals and Clinics, Department of Surgery, 200 Hawkins Dr, Iowa City, IA, 52242, USA
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  • James R. Howe
    Affiliations
    University of Iowa Hospitals and Clinics, Department of Surgery, 200 Hawkins Dr, Iowa City, IA, 52242, USA
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  • Sonia L. Sugg
    Affiliations
    University of Iowa Hospitals and Clinics, Department of Surgery, 200 Hawkins Dr, Iowa City, IA, 52242, USA
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  • Geeta Lal
    Correspondence
    Corresponding author. Department of Surgery Carver College of Medicine, University of Iowa Hospitals 200 Hawkins Drive, 4641 JCP, Iowa City, IA, 52242, USA.
    Affiliations
    University of Iowa Hospitals and Clinics, Department of Surgery, 200 Hawkins Dr, Iowa City, IA, 52242, USA
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally to this manuscript and are co-first authors.

      Highlights

      • Endocrine tumor board resulted in a change in management in 15% of presentations.
      • 43% of changes after discussion were related to additional imaging.
      • Over time, attendee surveys indicated a more evidence or guideline-based approach to practice.

      Abstract

      Background

      Multidisciplinary Tumor Boards (MDT) are used to obtain input regarding cancer management. This study assessed the impact of our institutional Endocrine MDT.

      Methods

      MDT notes on patients with thyroid cancer treated during 2012–2018 were abstracted retrospectively from the electronic medical record. Management change (MC) was prospectively collected by the MDT coordinator. Biannual evaluations reviewed the impact of the MDT as observed by attendees.

      Results

      MC was recommended in 47 (15%) of 286 presentations, with additional imaging being the most frequent (43%). Presentation of recurrences were more likely to result in MC (24% vs. 13% initial, p = 0.03). Overall, 98% of attendees found the conference exceeded educational expectations. About 24% reported intending to use a more evidence/guideline-based approach after attending and this trend increased over time (p = 0.002).

      Conclusion

      MDT presentations led to a higher rate of MC particularly in recurrent TC patients and increased evidenced-based practice for attendees.

      Keywords

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