How multidisciplinary are case discussions of breast and gynecologic cancer patients in tumor conferences? A mixed-methods study of healthcare realities and associated factors (INCASE)

• Applicant: Dr. Christian Heuser
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 533585301

Background: Tumor conferences (TC) are the central instrument for multidisciplinary healthcare of cancer patients and are intended to comprise medical and non-medical healthcare providers (HCP). TC are mandatory for certified cancer centers in Germany and usually take place on a weekly basis. In the case discussions of TC, diagnoses and guideline-based recommendations are discussed and agreed. However, initial studies indicate that case discussions are only limitedly multidisciplinary. In particular, the HCP of psycho-oncology and nursing are rarely present or rarely participate in case discussions. The aim of this study is to analyze for the first time in Germany a) how multidisciplinary case discussions of TC of breast and gynecological cancer patients are (healthcare realities) and b) which influencing factors are related to the multidisciplinarity of case discussions in TC (associated factors). Methods: Structured observational data, audio recordings and transcripts as well as patient survey data from the previous study PINTU ("Patient involvement in multidisciplinary tumor conferences", Deutsche Krebshilfe, 2017-2020) will be used. (I) All case discussion will be descriptively analyzed with regard to attendance, involvement and participation of all HCP and the content of the case discussions will be qualitatively analyzed using thematic analysis (aim a). (II) The resulting quantifiable variables will be triangulated with patient survey data. (III) Depending on the variable types, linear or logistic multiple regression analyses will be performed to identify possible influencing factors of multidisciplinarity of case discussion in TC (aim b). Results: N=306 case discussions of the included N=317 patients from N=6 cancer centers in North-Rhine-Westphalia, Germany, serve as data basis for the descriptive, multivariate and qualitative analyses in the context of the applied DFG study "INCASE". Discussion: The INCASE study will identify for the first time in Germany the healthcare realities of (multidisciplinary) case discussions in breast and gynecological cancer patients and possible influencing factors. The professional groups of psycho-oncology and nursing are particularly underrepresented in TC case discussions, despite studies suggesting that they can reinforce patient-centered care. Identifying factors influencing multidisciplinarity in case discussions in TC may be helpful in strengthening multidisciplinary and patient-centered care in oncology.

• DFG Programme: Research Grants
• International Connection: United Kingdom
• Co-Investigators: Professorin Dr. Lena Ansmann; Professorin Dr. Nicole Ernstmann
• Cooperation Partner: Dr. Tayana Soukup