MP11-11 VALIDATION AND IMPLEMENTATION OF A MOBILE APP DECISION SUPPORT SYSTEM FOR QUALITY ASSURANCE OF MULTIDISCIPLINARY TUMOR BOARDS (MTD) TO OPTIMIZE MANAGEMENT OF ADVANCED TESTICULAR CANCER

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer I (MP11)1 Apr 2020MP11-11 VALIDATION AND IMPLEMENTATION OF A MOBILE APP DECISION SUPPORT SYSTEM FOR QUALITY ASSURANCE OF MULTIDISCIPLINARY TUMOR BOARDS (MTD) TO OPTIMIZE MANAGEMENT OF ADVANCED TESTICULAR CANCER Yasemin Ural*, Thomas Elter, David Pfister, Michael Hallek, and Axel Heidenreich Yasemin Ural*Yasemin Ural* More articles by this author , Thomas ElterThomas Elter More articles by this author , David PfisterDavid Pfister More articles by this author , Michael HallekMichael Hallek More articles by this author , and Axel HeidenreichAxel Heidenreich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000831.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As has been shown recently guideline-compliance is suboptimal concerning the management of testis cancer. Guideline incompliance results in significantly impaired long-term survival. In order to facilitate guideline concordant decisions even in less experienced MTD, we developed a partially algorithm-driven and validated mobile app to provide evidence-based recommendations for first-line therapy. This App contains the latest guideline version and it is continuously updated to include results of practice changing clinical studies. It is the purpose of this study to analyse treatment decision made by MTD compared to guideline recommended therapy. METHODS: 302 testis cancer patients with tumor board decision were randomly selected from our data registry. We analyzed the concordance rates of the MTD recommendations with the query results of the digital App “Easy Oncology”. The query was done by 2 independent persons (urologist, oncologist) who were not aware of the MTD recommendation. MTD decisions were analysed dependent on clinical and IGCCCG stage at time of presentation. Concordance was defined whenever the APP-based recommendation matched MTD recommendation. We defined “non-concordance” when recommendations of APP and MTD did not match. Descriptive statistics and data analysis were done using SPSS Version 25. Correlation analysis of the cancer case characteristics was performed using the Kendalls Tau, Gamma, Pearson and Spearman tests. RESULTS: Median age was 35 years (18-82years, n=245). Clinical stages I, IIA-C, and III were identified in 32%, 37%, and 31%, resp. According to IGCCCG 56%, 18%, and 25% demonstrated good, intermediate, and poor prognosis, resp. 56% were non-seminomas and 44% were seminomas. 60%, 16%, and 7% of MTD decisions were related to 1st-line, 2nd, and 3rd line therapy whereas 18% dealt with follow up. There was no significant correlation between age and clinical stage (p=0,985), age and IGCCCG group (p=0,539), but there was a significant correlation between age and histology (p=0,004). The overall concordance rate was 99% (301/302). Concordance rates in CS I, IIA-C, and III were 100%, 98% and 99%, respectively. Concordance rates with regard to 1rst, 2nd and 3rd line therapy were 99% (135/136), 100%, and 88% (13/14). Identical high concordance rates were achieved by both reviewers. CONCLUSIONS: Based on the data achieved, our validated expert-created mobile decision support system demonstrates easy and reliable application in daily routine in an expert tertiary referral centre. The APP relies on guideline and trial based information and avoids MTD decisions by expert opinions. It might improve the MTD decision in less experienced MTDs which is currently evaluated in a prospective study. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e139-e139 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasemin Ural* More articles by this author Thomas Elter More articles by this author David Pfister More articles by this author Michael Hallek More articles by this author Axel Heidenreich More articles by this author Expand All Advertisement PDF downloadLoading ...