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Cost-effectiveness acceptability curve

Trainee-Driven Model Advances Peritoneal Cancer Guidelines

Publication Title: Cost-effectiveness of frontline eltrombopag with immunosuppressive therapy for severe aplastic anemia

Summary

Question
This study examined the organizational strategies and management techniques employed by the Peritoneal Surface Malignancy (PSM) Consortium to create consensus guidelines for managing specific cancer types. The researchers focused on leveraging trainee collaboration to establish updated care recommendations for conditions such as appendiceal tumors, gastric cancer, and malignant gastrointestinal obstruction.
Why it Matters
Consensus guidelines are crucial for ensuring standardized, evidence-based care across medical institutions, particularly for complex conditions such as peritoneal surface malignancies, which involve cancer spreading to the lining of the abdominal cavity. This research highlights how trainee-led collaboration can streamline guideline development while fostering professional growth. These strategies could serve as a model for other medical teams seeking to improve clinical practices efficiently and inclusively.
Methods
The PSM Consortium included 317 members from multiple disciplines and institutions. Over 17 months, the group used the Delphi method—a structured process for achieving consensus through iterative feedback—to update existing guidelines and create new ones. Nine trainees led disease-specific working groups, which included oncologists, pathologists, radiologists, and patient advocates. Communication tools such as hybrid meetings and project management platforms supported the collaboration.
Key Findings
The researchers found that a flat, trainee-driven organizational structure allowed rapid progress and dynamic decision-making. Trainee leaders coordinated disease-specific teams and synthesized feedback to finalize guidelines. Using small-world networks—groups of interconnected experts—improved collaboration and minimized redundancy. This approach produced updated guidelines for five cancer types and one new guideline for malignant gastrointestinal obstruction, supplemented by 11 systematic reviews.
Implications
The study demonstrates that trainee-led collaborations can effectively manage complex projects, such as developing consensus guidelines, while offering valuable mentorship opportunities. By reducing hierarchical bottlenecks and fostering collaborative decision-making, this model could be adapted for other fields to improve research efficiency, clinical care, and professional development. Additionally, it underscores the importance of balancing rigorous methodology with flexibility to meet project goals.
Next Steps
The researchers suggested that similar trainee-driven structures could be applied to other areas of medicine or adapted for non-academic settings by involving early-career professionals. They emphasized the need for replicable strategies and mentorship frameworks to support future collaborative efforts in generating consensus-driven research products.
Funding Information
This research was supported by the National Institutes of Health (NIH) NCI loan repayment program (award 1L30CA294369-01) and the NIH Immuno-Oncology Yale Cancer Center Advanced Training Program (award T32 CA233414). Additional support was provided by the Irving Harris Foundation. Yale University also provided funding and support for this research.

Full Citation

Ito S, Potnis K, Ng D, Patel K, Sra M, Shallis R, Podoltsev N, Kewan T, Stempel J, Mendez L, Huntington S, Stahl M, Zeidan A, Bewersdorf J, Goshua G. Cost-effectiveness of frontline eltrombopag with immunosuppressive therapy for severe aplastic anemia. Blood Red Cells & Iron 2026, 2: 100076. PMID: 42077391, PMCID: PMC13134686, DOI: 10.1016/j.brci.2026.100076.
This AI-assisted summary has been reviewed and approved by at least one of the study's authors to ensure it accurately reflects the research.

Authors

  • Satoko Ito, MD, PhD

    First Author
    Yale School of Medicine

    Postdoctoral Fellow

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  • George Goshua, MD, SM, FACP

    Last Author
    Yale School of Medicine

    Assistant Professor of Medicine (Hematology)

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Additional Yale School of Medicine Authors

Other Authors

  • Kunal C. Potnis;
  • Kishan K. Patel;
  • Tariq Kewan;
  • Jessica M. Stempel

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