Translation of knowledge to practice - Improving awareness in NSCLC molecular testing. - PubMed - NCBI
J Thorac Oncol. 2018 Mar 10. pii: S1556-0864(18)30187-4. doi: 10.1016/j.jtho.2018.03.005. [Epub ahead of print]
Translation of knowledge to practice - Improving awareness in NSCLC molecular testing.
Zer A1,
Cutz JC2,
Sekhon H3,
Hwang DM1,
Sit C1,
Maganti M1,
Sung M1,
Binnie M1,
Brade A1,
Chung TB1,
Kamel-Reid S1,
Narinder P1,
Tsao MS1,
Waddell T1,
da Cunha Santos G1,
Patel M4,
Carter RF2,
Leighl NB5.
Abstract
BACKGROUND:
Molecular testing in advanced lung cancer is standard in guiding treatment selection. However, population-wide implementation of testing remains a challenge. We developed a knowledge translation intervention to improve understanding among diagnostic specialists about molecular testing and appropriate diagnostic sampling in lung cancer. METHODS:
Specialty-specific education programs were developed from existing literature and input from Canadian leaders in lung pathology, respirology, interventional radiology, thoracic surgery, radiation and medical oncology. The programs, including key messages, review of current data, existing guidelines, group discussion and participant feedback, were administered at provincial and national specialty meetings. Participant knowledge was assessed before and after the intervention using anonymous questionnaires. Molecular testing rates (EGFR) in Ontario were also evaluated before and after the intervention period. RESULTS:
Ten programs were administered to diagnostic specialists including respirologists, pathologists, thoracic surgeons, radiologists, radiation and medical oncologists, with completion of 255 pre- and 219 post-intervention surveys. At baseline, 30% were unsure of tissue handling methods for molecular testing, 20% chose an incorrect technique and half were unfamiliar with how to initiate testing. Post-intervention, specialist knowledge improved regarding tissue handling, appropriate fixation techniques, and uncertainty decreased from 30% to 2% (p<0.001). A 12% increase (relative 57%) in molecular testing requests (EGFR) in Ontario was observed over the intervention period (p=0.0032). CONCLUSIONS:
Significant knowledge gaps exist among diagnostic specialists regarding molecular testing and targeted therapy in lung cancer. This initiative significantly improved understanding of the importance and methods of successful molecular testing, and correlated with increased testing rates. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
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