A consensus dataset for the management of conjunctival melanoma in the multidisciplinary setting

Abstract

AbstractImportanceA key tenet of best practice in modern oncology is multidisciplinary decision making. Currently there are no specific multidisciplinary guidelines for the management of conjunctival melanoma.BackgroundConjunctival melanoma is a rare disease which can be associated with significant morbidity and in some cases, mortality. Multidisciplinary care has been shown to improve outcomes for oncology patients. The aim of the current report is to determine a consensus dataset for the multidisciplinary management of conjunctival melanoma by surveying experts involved in the management of conjunctival melanoma.Design and participantsHealth professionals (n=86) who participate in a multi‐institutional ocular oncology multidisciplinary team (MDT) meetings at the Kinghorn Cancer Centre in Sydney, NSW were invited to participate in this studyMethodsA modified Delphi method with two rounds of online survey and one oral consensus round was carried out. Data fields relating to demographic, clinical, pathology and follow up information were collated from the American Joint Committees on Cancer TNM Staging Manual (8t edition) and Cancer Australia Government recommendations.Main Outcome MeasuresFields for inclusion in a consensus dataset.ResultsIn round one 43 of 86 participants (50%) responded. Nine out of 71 questions did not achieve 80% consensus and were added to round two. 32 professionals out of 43 (74%) responded to round two. None of the nine questions in this round achieved 80% consensus, and all nine were added to round three, the oral consensus round. 16 professionals out of 32 (50%) were present in this last round. The process generated a final dataset consisting of six demographic items), 31 clinical items, 32 pathology items and four items. In total, 75 fields were considered essential for multidisciplinary management of conjunctival melanoma.Conclusions and RelevanceUsing recognised methodology, this consensus dataset represents a working document and template for optimising patient care and multidisciplinary decision making for conjunctival melanoma. It can be used as a tool for evaluating and benchmarking MDT performance.