Association of Parental Status and Gender with Burden of Multidisciplinary Tumor Boards

B. L. Chau,J. S. LaGuardia,S. Kim, S. C. Zhang, E. Pletcher,N. N. Sanford, A. Raldow, L. Singer,J. Gong,S. Padda,M. Kamrava, T. Cohen,D. Mitra,K. M. Atkins

JAMA network open(2023)

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摘要
QuestionWhat is the burden of tumor boards among oncology physicians?FindingsIn this survey study of tumor board burden, identifying as a woman or a parent was associated with a significantly higher level of burden from early morning and/or late evening tumor boards. Having 2 or more children, attending 3 or more hours per week of tumor boards, or being a radiologist or pathologist was associated with a significantly higher level of burden overall.MeaningThis study suggests that future strategies should aim to decrease tumor board burden, particularly the disparate burden on parents, women, and/or specific specialists. Importance Tumor boards are integral to the care of patients with cancer. However, data investigating the burden of tumor boards on physicians are limited.Objective To investigate what physician-related and tumor board-related factors are associated with higher tumor board burden among oncology physicians.Design, Setting, and Participants Tumor board burden was assessed by a cross-sectional convenience survey posted on social media and by email to Cedars-Sinai Medical Center cancer physicians between March 3 and April 3, 2022. Tumor board start times were independently collected by email from 22 top cancer centers.Main Outcomes and Measures Tumor board burden was measured on a 4-point scale (1, not at all burdensome; 2, slightly burdensome; 3, moderately burdensome; and 4, very burdensome). Univariable and multivariable probabilistic index (PI) models were performed.Results Surveys were completed by 111 physicians (median age, 42 years [IQR, 36-50 years]; 58 women [52.3%]; 60 non-Hispanic White [54.1%]). On multivariable analysis, factors associated with higher probability of tumor board burden included radiology or pathology specialty (PI, 0.68; 95% CI, 0.54-0.79; P = .02), attending 3 or more hours per week of tumor boards (PI, 0.68; 95% CI, 0.58-0.76; P < .001), and having 2 or more children (PI, 0.65; 95% CI, 0.52-0.77; P = .03). Early or late tumor boards (before 8 am or at 5 pm or after) were considered very burdensome by 33 respondents (29.7%). Parents frequently reported a negative burden on childcare (43 of 77 [55.8%]) and family dynamics (49 of 77 [63.6%]). On multivariable analysis, a higher level of burden from early or late tumor boards was independently associated with identifying as a woman (PI, 0.69; 95% CI, 0.57-0.78; P = .003) and having children (PI, 0.75; 95% CI, 0.62-0.84; P < .001). Independent assessment of 358 tumor boards from 22 institutions revealed the most common start time was before 8 am (88 [24.6%]).Conclusions and Relevance This survey study of tumor board burden suggests that identifying as a woman or parent was independently associated with a higher level of burden from early or late tumor boards. The burden of early or late tumor boards on childcare and family dynamics was commonly reported by parents. Having 2 or more children, attending 3 or more hours per week of tumor boards, and radiology or pathology specialty were associated with a significantly higher tumor board burden overall. Future strategies should aim to decrease the disparate burden on parents and women.
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关键词
parental status,multidisciplinary tumor boards,physicians,gender
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