Demographic Influences on Awareness of Speech-Language Pathology Services in the U.S.

Multidisciplinary cancer care is the cornerstone of contemporary oncology. Tumor board (TB) meetings are routinely held at most institutions globally as a common method of facilitating multidisciplinary cancer care. Participants often include medical and radiation oncologists, surgeons, radiologists, pathologists, and ancillary staff members such as research nurses and administrative coordinators. These meetings serve as a forum to review diagnoses, patient factors, tumor biology, disease stage, treatment options, clinical trial eligibility, and to reach a consensus for management decisions, in concordance with current guidelines and standards of care. Prior research has found that TB meetings frequently lead to a change in clinical management and can be associated with improved guideline-concordant care, increased utilization of targeted therapies, increased clinical trial enrollment, and better overall patient outcomes. There are over 1400 cancer programs accredited by The American College of Surgeons’ Commission on Cancer (ACS CoC), which requires compliance with specific standards to obtain this designation. The ACS CoC’s accreditation standards, Optimal Resources for Cancer Care (2020 Standards), define a minimum of 15% of cases be presented at TB and outline key elements for discussion at TB meetings. Yet, no specific standards (from ACS CoC, National Comprehensive Cancer Network (NCCN), or American Society of Clinical Oncology (ASCO) exist for how to document the results of a TB meeting or even whether formal documentation is required. Previous efforts at developing standards and/or checklists for multidisciplinary TBs have also failed to include recommendations on documentation. Such documentation might include which attendees were present, the clinical information on which management decisions were based, final consensus recommendations, and whether the patient was notified of the recommendations. More recently, specialized accreditation organizations, such as the National Accreditation Program for Breast Centers (NAPBC) and National Accreditation for Rectal Cancer (NAPRC), have developed disease-specific recommendations, including documentation standards, yet adherence to these recommendations is unclear. Given the importance of multidisciplinary TBs in contemporary oncology and the lack of best practice standards for TB documentation, the purpose of this study was to characterize documentation practices at a single institution across diverse cancer specialties, including its prevalence, quality, and association with patient outcomes. These data are necessary to inform future work aimed at standardizing best practices for TB documentation, with the goal of facilitating the timely and accurate dissemination of multidisciplinary specialty oncology recommendations.