Aims
Optimal Care Pathways (OCPs) are the frameworks for best practice cancer care, with input from multidisciplinary expert working groups. The composition of these groups has not been examined, despite their perspectives shaping the OCP development. This study aims to appraise the diversity of these working groups by examining their gender, professional, geographic, and consumer composition.
Methods
Data was extracted from published cancer-specific OCPs (first and second edition), including publication dates and member details. The gender and affiliation location of members were identified using publicly available information, with location coded against the Modified Monash Model (MMM). Descriptive analyses were conducted.
Results
Working group composition was extracted for 22 editions across 15 OCPs. Only two OCPs (13%) had been updated within the last three years. Group size ranged from seven and 25 members (median=13). The proportion of women ranged from 20 to 83% (median=55%). Medical specialists were represented in all editions (100%) and comprised between 44% to 80% of each group. Representation of other disciplines was less consistent: nurses (represented in 82% of the OCP editions; comprising 0-27% of the group), general practitioners (41%; 0-13%), social workers (18%; 0-9%) and other allied health (50%; 0-11%). Consumer input was evident on 59% of OCP editions. Approximately 40% of OCPs (n=6/15) had members from at least four states or territories. Members primarily had urban and regional experience (MM1 67-100%; MM2 0-25%). Rural (MM3) representation was evident in only four OCPs, with no remote representation (MM4-7).
Conclusions
The lack of non-medical specialist representation, consumer voices and rural health perspectives may limit the representativeness of . There is a strong need for teams developing and updating OCPs to adopt approaches for more diverse working group composition, to ensure broad experiences are represented, and the developed pathways are inclusive, representative and suitable for implementation.