Analysis of management decisions and outcomes of a weekly multidisciplinary pediatric tumor board meeting in Uganda

• Published in: Future science OA Vol. 5; no. 9; p. FSO417
• Main Authors: George, Paul E, Fahdil, Geriga, Luutu, Israel, Bulamu, Alfred, Sekabira, John, Kakembo, Nasser, Nabadda, Susan, Kalungi, Sam, Kambugu, Joyce B
• Format: Journal Article
• Language: English
• Published: England Future Science Ltd 01.10.2019
• Subjects: Africa; multi-disciplinary tumor board; pediatric; Uganda; multi-disciplinary tumor board; Uganda; Africa; pediatric
• ISSN: 2056-5623; 2056-5623
• DOI: 10.2144/fsoa-2019-0070

To evaluate the efficacy of a pediatric multidisciplinary tumor board (MTB) in Uganda. We documented the discussion of cases presented at a pediatric MTB and subsequently, though retrospective chart review, determined the degree to which decision were implemented. 95 patients were discussed. In total, 129 of 226 (57%) distinct management decisions reached during the MTBs were implemented. Of these, 15 resulted in changes in diagnosis and 53 were classified as major changes in management. Decisions on chemotherapy were the most likely to be successfully enacted (51/58), followed by radiotherapy (18/30) and surgery (12/21). Labs/consults were less likely to be implemented. Key improvements, specifically in the documentation and implementation of management decisions, are needed to improve the MTB’s efficacy. Tumor board meetings, which are standard of care for cancer management and well-studied in high income settings, have not been appropriately evaluated in low-income settings. Therefore, we undertook a review of a weekly pediatric tumor board meeting in Uganda, in which we documented the patients discussed and management decisions reached. We found that many diverse patients were discussed in tumor board meetings, with important implications in diagnosis and management. However, many of the decisions reached in the meetings were not subsequently implemented, underscoring the need to improve the effectiveness of the tumor board meeting.