title: Addressing clinical trials: can the multidisciplinary Tumor Board improve participation? A study from an academic women's cancer program.
abstract: OBJECTIVE
  The Tumor Board (TB) allows for an interdisciplinary approach to cancer treatment designed to encourage evidence-based treatment. However, its role in facilitating clinical trial participation has not been reported. We aimed to determine whether a prospective TB is an effective strategy for trial recruitment and to identify steps within the TB process that facilitate discussion of trial eligibility and optimize accrual.
  
  
  METHODS
  We conducted a retrospective cross-sectional analysis of women presented to Gynecologic Oncology TB between March and December 2008. Patient demographics, TB recommendations, and post-TB patient discussions were abstracted. These were compared to data derived from the Department of Oncology Research to determine research team awareness of eligible patients and confirm trial enrollment(s). Data analysis was completed with Chi-square test; risk ratios and confidence intervals were calculated as summary measures.
  
  
  RESULTS
  We reviewed 1213 case presentations involving 916 women. Overall, 358 TB recommendations (30%) identified eligible patients, of which enrollment consisted of 87 (24%) trials (6% therapeutic trials and 18% non-therapeutic trials). Compared to other types of TB recommendations, those involving trials were discussed less frequently at post-TB patient visits (79% vs. 44%). Documentation of trial discussion at the post-TB visit was more likely to result in trial participation, versus solely relying on the research staff to communicate enrollment eligibility with the treating team (RR 2.5, p=0.006).
  
  
  CONCLUSIONS
  Patients identified by the TB were 2.5-times as likely to enroll in a clinical trial, but trials were mentioned only 44% of the time. Interventions that facilitate trial discussions during post-TB meetings are needed to improve trial participation.
authors.affiliation: Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Kuroki
authors.forename: Ashley
authors.initials: A
authors.lastname: Stuckey
authors.forename: Priya
authors.initials: P
authors.lastname: Hirway
authors.forename: Christina A
authors.initials: CA
authors.lastname: Raker
authors.forename: Christina A
authors.initials: CA
authors.lastname: Bandera
authors.forename: Paul A
authors.initials: PA
authors.lastname: DiSilvestro
authors.forename: Cornelius O
authors.initials: CO
authors.lastname: Granai
authors.forename: Robert D
authors.initials: RD
authors.lastname: Legare
authors.forename: Bachir J
authors.initials: BJ
authors.lastname: Sakr
authors.forename: Don S
authors.initials: DS
authors.lastname: Dizon
mesh_terms: D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D006176:Gynecology; D006801:Humans; D008495:Medical Oncology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D018579:Patient Selection; D012189:Retrospective Studies; D055815:Young Adult