2.1 Participants and definitions
Potential survey centers and participants were identified through membership records of regional professional associations and scientific meetings, particularly the St. Jude-VIVA Forum in Pediatric Oncology and ASEAN Society of Pediatric Surgeons. This research study (SHS/CIRB/2020/2020) was granted IRB waiver.
We defined pediatric solid tumor units (PSTUs) as institutional departments that care for pediatric solid tumors, with at least 1 pediatric oncologist or 1 pediatric surgeon who are either in-house or employed in a part-time capacity. Multidisciplinary tumor boards (MDTBs) were defined as any formal meeting attended by at least pediatric oncologists and pediatric surgeons, together with one more related subspecialty (pediatric-trained or general radiologists, radiation oncologists, pathologists, nuclear medicine physicians and nurses).
For the first part of the study, we included all PSTUs from Southeast Asian LMICs with at least one respondent (either pediatric oncologist or pediatric surgeon) in order to profile the available specialties and MDTBs at each PSTU. Exclusion criteria were refusal to participate or non-response, and incomplete or delayed responses beyond study period. For the survey in the second part of the study, only PSTUs with MDTBs were involved.
Development and conduct of survey
From the 46 Southeast Asian PSTUs, centers with MDTBs were shortlisted for the full survey. From this subset of PSTUs with MDTBs, 1 pediatric surgeon and 1 pediatric oncologist from each center were contacted via email to complete the survey via an online electronic form or a manual form. Automatic online language translation was used in the former to assist with respondents with difficulty with English language. Following two weeks given for response, a second oncologist or surgeon from the PSTU was contacted, failing which a null response was recorded.
Survey questions were adapted from published surveys on MDTB organization and dynamics 23-25, and drafted in English. The survey was composed of three main parts. First, to profile the respondents, they were asked about their type of specialty, years of practice and their estimated oncology workload. Next, to profile the center’s MDTB, respondents were queried about the frequency, attendance of MDTB members and available resources, and finally, their views on MDTBs using a 5-point Likert scale.