Does attending a Delphi consensus conference impact surgeon attitudes? Survey results from the Americas HepatoPancreatoBiliary Association consensus conference on small asymptomatic pancreatic neuroendocrine tumors.


Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921

Informations de publication

Date de publication:
05 2019
Historique:
received: 09 08 2018
revised: 02 10 2018
accepted: 05 10 2018
pubmed: 18 11 2018
medline: 9 4 2020
entrez: 17 11 2018
Statut: ppublish

Résumé

Management of asymptomatic small well-differentiated (panNET) <2 cm remains controversial. A consensus conference was held on this topic. The impact of attending the conference and participating in the audience response survey on surgeon's clinical approach to pancreatic neuroendocrine tumors was assessed. Audience members were surveyed using a smartphone real-time response system at the beginning and end of the conference. The majority of 75 attendees underwent fellowship training, and 30% had >10 years experience as attending surgeons. Previously published consensus statements on the topic were considered insufficient to guide surgical practice by 82% of attendees, and over 96% desired additional data. After review of the data, consensus statements, and decision-making process, a significant number of participants changed their opinions regarding indications for tissue biopsy (p = 0.001), size thresholds for excision (p = 0.002), and regional lymph node dissection (p = 0.002) independent of whether a consensus was reached by the content-expert panel. This represented the first Delphi process consensus on the topic, and the survey confirmed the topic as well-chosen and timely. Attendees changed opinions on management of panNET regardless of whether formal consensus was reached. Therefore, statements of consensus combined with presentation of literature and live discussion served to impact attendees' approach to this disease.

Sections du résumé

BACKGROUND
Management of asymptomatic small well-differentiated (panNET) <2 cm remains controversial. A consensus conference was held on this topic. The impact of attending the conference and participating in the audience response survey on surgeon's clinical approach to pancreatic neuroendocrine tumors was assessed.
METHODS
Audience members were surveyed using a smartphone real-time response system at the beginning and end of the conference.
RESULTS
The majority of 75 attendees underwent fellowship training, and 30% had >10 years experience as attending surgeons. Previously published consensus statements on the topic were considered insufficient to guide surgical practice by 82% of attendees, and over 96% desired additional data. After review of the data, consensus statements, and decision-making process, a significant number of participants changed their opinions regarding indications for tissue biopsy (p = 0.001), size thresholds for excision (p = 0.002), and regional lymph node dissection (p = 0.002) independent of whether a consensus was reached by the content-expert panel.
CONCLUSIONS
This represented the first Delphi process consensus on the topic, and the survey confirmed the topic as well-chosen and timely. Attendees changed opinions on management of panNET regardless of whether formal consensus was reached. Therefore, statements of consensus combined with presentation of literature and live discussion served to impact attendees' approach to this disease.

Identifiants

pubmed: 30442562
pii: S1365-182X(18)34474-5
doi: 10.1016/j.hpb.2018.10.001
pii:
doi:

Types de publication

Consensus Development Conference Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

524-530

Investigateurs

Suzanne Warner (S)
Robert Warren (R)
Charles St Hill (C)
Scott Celinski (S)
Quan Ly (Q)
James Howe (J)
Steven Libutti (S)

Informations de copyright

Copyright © 2018 International Hepato-Pancreato-Biliary Association Inc. All rights reserved.

Auteurs

Ajay V Maker (AV)

Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: amaker@uic.edu.

Thuy B Tran (TB)

Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.

Natalie Coburn (N)

Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, USA.

Zhi V Fong (ZV)

Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.

Kenneth Cardona (K)

Department of Surgery, Emory University, Atlanta, GA, USA.

Philippa Newell (P)

Department of Surgery, Providence Portland Medical Center, Portland, OR, USA.

Gareth Morris-Stiff (G)

Department of Surgery, Cleveland Clinic, Cleveland, OH, USA.

Kenneth Chavin (K)

Department of Surgery, University Hospitals, Cleveland, OH, USA.

John Mansour (J)

Department of Surgery, UT Southwestern, Dallas, TX, USA.

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Classifications MeSH