19 Developing a Teenage and Young Adult Brain Tumour Standard Operating Procedure in a UK Tertiary Neurosciences Centre

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Abstract Introduction Teenage and Young Adult (TYA) patients aged 16–24 years represent a biologically and clinically distinct cohort of central nervous system (CNS) tumour patients. Despite national standards for TYA cancer care, no dedicated management pathway for TYA brain tumours exists at Trust or national level. We developed a Trust-wide Standard Operating Procedure (SOP) for TYA CNS tumours at University Hospitals Birmingham (UHB), alongside an artificial intelligence (AI)-assisted framework for structured SOP development and optimisation. Methods Literature review identified no Trust-specific or UK national guidance dedicated to TYA brain tumour pathways. A draft SOP was developed using ChatGPT-5, a large language model (LLM), guided by structured prompts referencing SIOP Europe Brain Tumour Group consensus guidance, NICE standards, and NHS England TYA service specifications. The LLM supported drafting and formatting but did not replace clinical oversight. Multidisciplinary consensus was achieved using a modified Digital Delphi methodology with anonymous 5-point Likert voting. The predefined scope included referral, investigation, MDT processes, surgical and oncological pathways, tumour-specific follow-up, and late-effects surveillance for patients aged 16–24 years. Consensus was defined as ≥ 80% agreement. In parallel, we developed an SOP Quality Assessment Tool and applied readability analysis (Flesch-Kincaid, SMOG, Gunning Fog) to existing Neurosurgery SOPs. LLM-assisted prompt engineering was used to reformat narrative-heavy SOPs into structured, checklist-driven templates, which were then applied to the TYA pathway. Results A consensus-based Trust-wide SOP was developed and ratified. AI-assisted reformatting improved structural clarity and usability, enabling development of a standardised template for TYA brain tumour management. Conclusions There is a clear gap in guidance for TYA brain tumour pathways. We demonstrate a scalable, consensus-driven, AI-assisted model for SOP development that could support standardisation of TYA neurooncology care regionally and nationally.