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Gestational Trophoblastic Disease ECHO
10 steps to setting up a GTD center
10 steps to setting up a GTD center
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Video Summary
John Coulter describes how he helped establish Ireland’s national gestational trophoblastic disease (GTD) center and outlines 10 key steps for creating similar centers elsewhere. He emphasizes that GTD and gestational trophoblastic neoplasia (GTN) are rare, so centralizing care improves diagnosis, treatment efficiency, and patient survival.<br /><br />His main steps include: building awareness among colleagues, creating local/regional/national guidelines, developing a strong business case, securing funding, assembling a multidisciplinary team, defining clear clinical pathways, establishing clinical governance, linking with international societies, and maintaining continuous audit and research. He stresses the importance of enthusiastic leadership, support from pathologists, biochemists, radiologists, oncologists, and nurse specialists, and close collaboration with referring clinicians.<br /><br />Coulter explains that guidelines and formal registration of patients are crucial for standardizing care and helping justify funding. He also notes that patient advocacy and public pressure can sometimes help drive system change. In the Q&A, a participant from Bangladesh raises concerns about lack of insurance and follow-up barriers; Coulter responds that advocacy for free, centralized care is especially important because GTD is curable and affects young women.<br /><br />He closes by encouraging others to persist, collaborate, and use international networks, and he announces upcoming GTD educational meetings.
Keywords
gestational trophoblastic disease
gestational trophoblastic neoplasia
centralized care
multidisciplinary team
clinical guidelines
clinical governance
patient advocacy
international collaboration
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