Global Cancer Institute (GCI) multi-disciplinary tumor boards (MTBs) as an educational tool to improve guideline-based cancer clinical practice in low- and middle-income countries (LMICs).

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e18007-e18007
Author(s):  
Jessica St. Louis ◽  
Alexandra Bukowski ◽  
Rossana Esther Ruiz Mendoza ◽  
Carmen Herrero Vincent ◽  
Abraham Hernandez Blanquisett ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Educational Tool ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tumor Boards ◽  
Low And Middle Income

Data on cerebral palsy in Vietnam will inform clinical practice and policy in low and middle-income countries

2021 ◽  
pp. 1-8
Author(s):  
Tasneem Karim ◽  
Rachael Dossetor ◽  
Nguyen Thi Huong Giang ◽  
Trinh Quang Dung ◽  
Tran Vinh Son ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Clinical Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Promoting Tobacco Cessation in Low- and Middle-Income Countries

2016 ◽  
Vol 11 (2) ◽  
pp. 66-69 ◽  
Author(s):  
Harry A. Lando
Keyword(s):  
Clinical Practice ◽  
Tobacco Cessation ◽  
High Income ◽  
Limited Resources ◽  
Public Knowledge ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tobacco Epidemic ◽  
Who 2008 ◽  
Low And Middle Income

The tobacco epidemic is increasingly concentrated in low- and middle-income countries (LMICs) (WHO, 2008). These countries often have very limited resources and infrastructure to confront this epidemic. Public knowledge of tobacco health harms may be quite limited and, unfortunately, this is often true for health professionals as well (Nichter, 2006). Clinical practice guidelines have identified effective tobacco cessation interventions (Clinical Practice Guideline, 2008), but these have been focused primarily upon high-income countries. Approaches that have been successful in high-income countries may not be directly applicable in low-resource settings. Thus, for example, medications may not be readily accessible and infrastructure to support quit line programs may be minimal or non-existent.

scholarly journals Pediatric Solid Tumor Care and Multidisciplinary Tumor Boards in Low- and Middle-Income Countries in Southeast Asia

2020 ◽  
pp. 1328-1345
Author(s):  
Mohd Yusran Othman ◽  
Sally Blair ◽  
Shireen A. Nah ◽  
Hany Ariffin ◽  
Chatchawin Assanasen ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Solid Tumor ◽  
Specialist Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pediatric Solid Tumors ◽  
Tumor Boards ◽  
Pediatric Solid Tumor ◽  
Pediatric Oncologist ◽  
Low And Middle Income

PURPOSE Pediatric solid tumors require coordinated multidisciplinary specialist care. However, expertise and resources to conduct multidisciplinary tumor boards (MDTBs) are lacking in low- and middle-income countries (LMICs). We aimed to profile the landscape of pediatric solid tumor care and practices and perceptions on MDTBs among pediatric solid tumor units (PSTUs) in Southeast Asian LMICs. METHODS Using online surveys, availability of specialty manpower and MDTBs among PSTUs was first determined. From the subset of PSTUs with MDTBs, one pediatric surgeon and one pediatric oncologist from each center were queried using 5-point Likert scale questions adapted from published questionnaires. RESULTS In 37 (80.4%) of 46 identified PSTUs, availability of pediatric-trained specialists was as follows: oncologists, 94.6%; surgeons, 91.9%; radiologists, 54.1%; pathologists, 40.5%; radiation oncologists, 29.7%; nuclear medicine physicians, 13.5%; and nurses, 81.1%. Availability of pediatric-trained surgeons, radiologists, and pathologists was significantly associated with the existence of MDTBs ( P = .037, .005, and .022, respectively). Among 43 (89.6%) of 48 respondents from 24 PSTUs with MDTBs, 90.5% of oncologists reported > 50% oncology-dedicated workload versus 22.7% of surgeons. Views on benefits and barriers did not significantly differ between oncologists and surgeons. The majority agreed that MDTBs helped to improve accuracy of treatment recommendations and team competence. Complex cases, insufficient radiology and pathology preparation, and need for supplementary investigations were the top barriers. CONCLUSION This first known profile of pediatric solid tumor care in Southeast Asia found that availability of pediatric-trained subspecialists was a significant prerequisite for pediatric MDTBs in this region. Most PSTUs lacked pediatric-trained pathologists and radiologists. Correspondingly, gaps in radiographic and pathologic diagnoses were the most common limitations for MDTBs. Greater emphasis on holistic multidisciplinary subspecialty development is needed to advance pediatric solid tumor care in Southeast Asia.

scholarly journals Better Outcomes through Learning, Data, Engagement, and Research (BOLDER) – a system for improving evidence and clinical practice in low and middle income countries

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 693 ◽  
Author(s):  
Keyword(s):  
Clinical Practice ◽  
Health Systems ◽  
Routine Clinical Practice ◽  
Governance System ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Relevant Evidence ◽  
The Many ◽  
Low And Middle Income

Despite the many thousands of research studies published every year, evidence for making clinical decisions is often lacking. The main problem is that the evidence available is generated in conditions very different from those that prevail in routine clinical practice and with patients who are different. This is particularly a problem for low and middle income countries as most evidence is generated in high income countries.A group of clinicians, researchers, and policy makers met at Bellagio in Italy to consider how more relevant evidence might be generated. One answer is to conduct more pragmatic trials—those undertaken in routine clinical practice. The group thought that this might best be achieved by developing “learning health systems” in low and middle income countries.Learning health systems develop in communities that include clinicians, patients, researchers, improvement specialists, information technology specialists, managers, and policy makers and have a governance system that gives a voice to all those in the community. The systems focus on improving outcomes for patients, use a common dataset, and promote quality improvement and pragmatic research. Plans have been developed to create at least two learning systems in Africa.

Gynecologic pathology services in low- and middle-income countries

2021 ◽  
pp. ijgc-2021-003103
Author(s):  
Ekaternia Olkhov-Mitsel ◽  
Fang-I Lu ◽  
Anna Gagliardi ◽  
Anna Plotkin
Keyword(s):  
Online Education ◽  
Central America ◽  
Gynecologic Cancer ◽  
Molecular Testing ◽  
Subspecialty Training ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tumor Boards ◽  
The Caribbean ◽  
Low And Middle Income

ObjectiveThe International Gynecologic Cancer Society (IGCS) offers multidisciplinary conferences to underserved communities. Mentor pathologists have become an integral part of these tumor boards, as pathology services in low-to-middle-income countries are often inadequate and disjointed. The IGCS Pathology Working Group conducted a survey to assess barriers to quality pathology services in low-to-middle-income countries and identified potential solutions.MethodsA 69-question cross-sectional survey assessing different aspects of pathology services was sent to 15 IGCS Extension for Community Healthcare Outcomes (ECHO) training sites in Africa, Asia, Central America, and the Caribbean. Local gynecologic oncologists distributed the survey to their pathology departments for review. The responses were tabulated in Microsoft Excel.ResultsResponses were received from nine training sites: five sites in Africa, two in Asia, one in Central America, and one in the Caribbean. There were no pathologists with subspecialty training in gynecologic pathology. Most (7/9, 78%) surveyed sites indicated that they have limited access to online education and knowledge transfer resources. Of the eight sites that responded to the questions, 50% had an electronic medical system and 75% had a cancer registry. Synoptic reporting was used in 75% of the sites and paper-based reporting was predominant (75%). Most (6/7, 86%) laboratories performed limited immunohistochemical stains on site. None of the sites had access to molecular testing.ConclusionsInitial goals for collaboration with local pathologists to improve diagnostic pathology in low- and middle-income countries could be defining minimal gross, microscopic, and reporting pathology requirements, as well as wisely designed educational programs intended to mentor local leaders in pathology. Larger studies are warranted to confirm these observations.

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