1
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Mehta SN, Shenvi EC, Blair SL, Caudle A, Lowenstein LM, Kelly KJ. Leveraging the Multidisciplinary Tumor Board for Dissemination of Evidence-Based Recommendations on the Staging and Treatment of Gastric Cancer: A Pilot Study. Ann Surg Oncol 2023; 30:1120-1129. [PMID: 36222932 PMCID: PMC9555252 DOI: 10.1245/s10434-022-12628-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/13/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Compliance with evidence-based treatment guidelines for gastric cancer across the United States is poor. This pilot study aimed to create and evaluate a change package for disseminating information on the staging and treatment of gastric cancer during multidisciplinary tumor boards and for identifying barriers to implementation. METHODS The change package included a 10-min video, a brief knowledge assessment, and a discussion guide. Commission on Cancer-accredited sites that perform gastrectomy were invited to participate. Participants completed the Organizational Readiness for Implementing Change (ORIC) scale (range, 12-60) and scales to measure the feasibility, acceptability, and appropriateness (score range, 4-20). Semi-structured interviews were conducted to further define inner and outer setting barriers. RESULTS Seven centers participated in the study. A total of 74 participants completed the pre-video knowledge assessment, and 55 participants completed the post-video assessment. The recommendations found to be most controversial were separate staging laparoscopy and modified D2 lymphadenectomy. Sum scores were calculated for acceptability (mean, 17.43 ± 2.51) appropriateness (mean, 16.86 ± 3.24), and feasibility (mean, 16.14 ± 3.07) of the change package. The ORIC scores (mean, 46.57 ± 8.22) correlated with responses to the open-ended questions. The key barriers identified were patient volume, skills in the procedures, and attitudes and beliefs. CONCLUSIONS The change package was moderately to highly feasible, appropriate, and acceptable. The activity identified specific recommendations for gastric cancer care that are considered controversial and local barriers to implementation. Future efforts could focus on building skills and knowledge as well as the more difficult issue of attitudes and beliefs.
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Affiliation(s)
- Shivani N. Mehta
- Department of Surgery, University of California, San Diego, CA USA
| | - Edna C. Shenvi
- Department of Surgery, University of California, San Diego, CA USA
| | - Sarah L. Blair
- Department of Surgery, University of California, San Diego, CA USA
| | - Abigail Caudle
- Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lisa M. Lowenstein
- Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Kaitlyn J. Kelly
- Department of Surgery, University of California, San Diego, CA USA
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2
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Niyibizi BA, Muhizi E, Rangira D, Ndoli DA, Nzeyimana IN, Muvunyi J, Irakoze M, Kazindu M, Rugamba A, Uwimana K, Cao Y, Rugengamanzi E, de Dieu Kwizera J, Manirakiza AVC, Rubagumya F. Multidisciplinary approach to cancer care in Rwanda: the role of tumour board meetings. Ecancermedicalscience 2023; 17:1515. [PMID: 37113712 PMCID: PMC10129399 DOI: 10.3332/ecancer.2022.1515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Indexed: 04/29/2023] Open
Abstract
Introduction Cancer treatment is complex and necessitates a multidisciplinary approach. Tumour Board Meetings (TBMs) provide a multidisciplinary platform for health care providers to communicate about treatment plans for patients. TBMs improve patient care, treatment outcomes and, ultimately, patient satisfaction by facilitating information exchange and regular communication among all parties involved in a patient's treatment. This study describes the current status of case conference meetings in Rwanda including their structure, process and outcomes. Methods The study included four hospitals providing cancer care in Rwanda. Data gathered included patients' diagnosis, number of attendance and pre-TBM treatment plan, as well as changes made during TBMs, including diagnostic and management plan changes. Results From 128 meetings that took place at the time of the study, Rwanda Military Hospital hosted 45 (35%) meetings, King Faisal Hospital had 32 (25%), Butare University Teaching Hospital (CHUB) had 32 (25%) and Kigali University Teaching Hospital (CHUK) had 19 (15%). In all hospitals, General Surgery 69 (29%) was the leading speciality in presenting cases. The top three most presented disease site were head and neck 58 (24%), gastrointestinal 28 (16%) and cervix 28 (12%). Most (85% (202/239)) presented cases sought inputs from TBMs on management plan. On average, two oncologists, two general surgeons, one pathologist and one radiologist attended each meeting. Conclusion TBMs in Rwanda are increasingly getting recognised by clinicians. To influence the quality of cancer care provided to Rwandans, it is crucial to build on this enthusiasm and enhance TBMs conduct and efficiency.
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Affiliation(s)
| | - Eulade Muhizi
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Gynecology, Munini District Hospital, Nyabihu, Rwanda
| | - Daniella Rangira
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto M5T 3M7, Canada
| | - Diane A Ndoli
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
| | | | - Jackson Muvunyi
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
| | - Magnifique Irakoze
- Department of Gynecology, Kigali University Teaching Hospital, Kigali, Rwanda
| | - Madeleine Kazindu
- Rwanda Cancer Relief, Kigali, Rwanda
- School of Medicine, College of Medical and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Alex Rugamba
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Internal Medicine, Ruhango Provincial Hospital, Ruhango, Rwanda
| | - Khadidja Uwimana
- Rwanda Cancer Relief, Kigali, Rwanda
- School of Medicine, College of Medical and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Yuanzhen Cao
- Department of Internal Medicine, Dartmouth–Hitchcock Medical Center, Lebanon, NH 03766, USA
| | - Eulade Rugengamanzi
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Jean de Dieu Kwizera
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Internal Medicine, Gisenyi Hospital, Rubavu, Gisenyi, Rwanda
| | - Achille VC Manirakiza
- Rwanda Cancer Relief, Kigali, Rwanda
- Unit of Oncology, Department of Internal Medicine, King Faisal Hospital, Kigali, Rwanda
| | - Fidel Rubagumya
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
- School of Medicine, College of Medical and Health Sciences, University of Rwanda, Kigali, Rwanda
- Unit of Oncology, Department of Internal Medicine, King Faisal Hospital, Kigali, Rwanda
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3
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Di Pilla A, Cozzolino MR, Mannocci A, Carini E, Spina F, Castrini F, Grieco A, Messina R, Damiani G, Specchia ML. The Impact of Tumor Boards on Breast Cancer Care: Evidence from a Systematic Literature Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14990. [PMID: 36429708 PMCID: PMC9690234 DOI: 10.3390/ijerph192214990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is the most common malignancy in women, with a complex clinical path that involves several professionals and that requires a multidisciplinary approach. However, the effectiveness of breast cancer multidisciplinary care and the processes that contribute to its effectiveness have not yet been firmly determined. This study aims to evaluate the impact of multidisciplinary tumor boards on breast cancer care outcomes. A systematic literature review was carried out through Scopus, Web of Science and Pubmed databases. The search was restricted to articles assessing the impact of MTB implementation on breast cancer care. Fourteen studies were included in the review. The most analyzed outcomes were diagnosis, therapy and survival. Four out of four studies showed that, with implementation of an MTB, there was a change in diagnosis, and all reported changes in the treatment plan after MTB implementation. A pooled analysis of three studies reporting results on the outcome "mortality" showed a statistically significant 14% reduction in mortality relative risk for patients enrolled versus not enrolled in an MTB. This study shows that MTB implementation is a valuable approach to deliver appropriate and effective care to patients affected by breast cancer and to improve their outcomes.
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Affiliation(s)
- Andrea Di Pilla
- Clinical Governance Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | | | - Alice Mannocci
- Faculty of Economics, Università “Universitas Mercatorum”, Piazza Mattei 10, 00186 Rome, Italy
| | | | - Federica Spina
- Department of Maternal, Children and Adult Medical and Surgical Sciences, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, Italy
| | - Francesco Castrini
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Albino Grieco
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Rosaria Messina
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Gianfranco Damiani
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Maria Lucia Specchia
- Clinical Governance Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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4
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Guilabert M, Prades J, Borras JM, Maestu I, Guerra JA, Fumadó L, Mira JJ. A Web-Based Self-assessment Model for Evaluating Multidisciplinary Cancer Teams in Spain: Development and Validation Pilot Study. J Med Internet Res 2022; 24:e29063. [PMID: 35266870 PMCID: PMC8949680 DOI: 10.2196/29063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/02/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Tumor boards constitute the main consensus and clinical decision–making body of multidisciplinary teams (MDTs) in cancer care. With the increasing clinical complexity of treatment options (eg, targeted therapies, multimodal treatments) and the progressive incorporation of new areas of intervention (eg, survivorship care), tumor boards are now required to play a central role in all cancer processes. However, although frameworks are in place to evaluate MDT quality, only few web-based tools are available for this purpose; indeed, no web-based MDT evaluation tools have been developed for or adapted to the Spanish National Health System. Objective The first aim of this study was to develop a web-based self-assessment model (Autoevaluación de Equipos Multidisciplinares de Atención al Cáncer [AEMAC]) for evaluating multidisciplinary cancer teams in Spain and the second aim was to validate this tool by testing its metric properties, acceptability, and usability. Methods We designed and validated the AEMAC program in 3 stages. In the first stage (research), we reviewed the available scientific evidence and performed a qualitative case study of good practice in multidisciplinary care within the Spanish National Health System (n=4 centers and 28 health care professionals). The results were used to define the thematic areas and quality criteria for the self-evaluation model, which were then discussed and validated by a group of experts. The second stage (development) involved the technological development of a web app that would be accessible from any mobile device. In the third stage (piloting and validation), we conducted 4 pilot tests (n=15 tumor boards, 243 professionals) and used the results to analyze the acceptability and usefulness of the tool. Results We designed a self-assessment model based on 5 thematic areas encompassing a total of 25 quality components, which users rated on a 3-option development scale. The evaluation process, which was managed entirely from the web app, consisted of individual self-assessment, group prioritization, and creation of an improvement plan. Cronbach alpha (.86), McDonald’s omega (0.88), and various fit indices (comparative fit index between 0.95 and 1 and goodness-of-fit index between 0.97 and 0.99 for all 5 aspects) confirmed internal consistency. The mean rating for overall satisfaction with the tool and for consistency between the content of the tool and the reality of tumor boards was 7.6 out of 10. Conclusions The results obtained during the period of research and piloting of the AEMAC program showed that it has an appropriate structure and metric properties and could therefore be implemented in a real context and generalized to other hospitals. As a virtual tool, it helps to measure the key aspects of MDT quality, such as effectiveness of collaboration and communication, leadership, and the organizational environment.
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Affiliation(s)
| | - Joan Prades
- Department of Health, Catalonian Cancer Strategy, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Instituto de Investigación Biomédica de Bellvitge, Barcelona, Spain
| | - Josep M Borras
- Department of Health, Catalonian Cancer Strategy, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Instituto de Investigación Biomédica de Bellvitge, Barcelona, Spain
| | - Inmaculada Maestu
- Medical Oncology Service, Doctor Peset University Hospital, Valencia, Spain
| | - Juan Antonio Guerra
- Department of Hematology and Oncology, Fuenlabrada University Hospital, Fuenlabrada, Spain
| | - Lluís Fumadó
- Urological Cancer Functional Unit, Hospital del Mar-Parc de Salut Mar-IMIM, Barcelona, Spain
| | - José Joaquin Mira
- Health Psychology Department, Miguel Hernandez University, Elche, Spain.,Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain.,Alicante-Sant Joan Health Department, Alicante, Spain
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- see Authors' Contributions,
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5
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Ntalos D, Schoof B, Thiesen DM, Viezens L, Kleinertz H, Rohde H, Both A, Luebke A, Strahl A, Dreimann M, Stangenberg M. Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis. Sci Rep 2021; 11:9515. [PMID: 33947939 PMCID: PMC8096947 DOI: 10.1038/s41598-021-89088-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/19/2021] [Indexed: 12/17/2022] Open
Abstract
Establishing a multidisciplinary approach regarding the treatment of spondylodiscitis and analyzing its effect compared to a single discipline approach. 361 patients diagnosed with spondylodiscitis were included in this retrospective pre-post intervention study. The treatment strategy was either established by a single discipline approach (n = 149, year 2003–2011) or by a weekly multidisciplinary infections conference (n = 212, year 2013–2018) consisting of at least an orthopedic surgeon, medical microbiologist, infectious disease specialist and pathologist. Recorded data included the surgical and antibiotic strategy, complications leading to operative revision, recovered microorganisms, as well as the total length of hospital and intensive care unit stay. Compared to a single discipline approach, performing the multidisciplinary infections conference led to significant changes in anti-infective and surgical treatment strategies. Patients discussed in the conference showed significantly reduced days of total antibiotic treatment (66 ± 31 vs 104 ± 31, p < 0.001). Moreover, one stage procedures and open transpedicular screw placement were more frequently performed following multidisciplinary discussions, while there were less involved spinal segments in terms of internal fixation as well as an increased use of intervertebral cages instead of autologous bone graft (p < 0.001). Staphylococcus aureus and Staphylococcus epidermidis were the most frequently recovered organisms in both patient groups. No significant difference was found comparing inpatient complications between the two groups or the total in-hospital stay. Implementation of a weekly infections conference is an effective approach to introduce multidisciplinarity into spondylodiscitis management. These conferences significantly altered the treatment plan compared to a single discipline approach. Therefore, we highly recommend the implementation to optimize treatment modalities for patients.
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Affiliation(s)
- D Ntalos
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - B Schoof
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - D M Thiesen
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - L Viezens
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - H Kleinertz
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - H Rohde
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - A Both
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - A Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - A Strahl
- Division of Orthopedics, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - M Dreimann
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - M Stangenberg
- Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Zereshkian A, Forman J, Menjak I, Mehta R, Bristow B, Trudeau M, Gibson L, Neve MV, Norris M, Pasetka M, Wright FW, Rice K, McCullock F, Karim A, Szumacher E. Assessment of communication gaps among referring physicians and the multi-disciplinary team at the senior women breast Cancer clinic (SWBCC), Sunnybrook health sciences Centre, Toronto, Ontario, Canada. J Geriatr Oncol 2020; 12:676-679. [PMID: 33071212 DOI: 10.1016/j.jgo.2020.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Arman Zereshkian
- Undergraduate Medical Education, University of Toronto, Toronto, Ontario, Canada
| | - Jamie Forman
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Ines Menjak
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Rajin Mehta
- Department of Geriatric Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Bonnie Bristow
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Maureen Trudeau
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Leslie Gibson
- Department of Occupational Therapy Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Matthew V Neve
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mireille Norris
- Department of Geriatric Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mark Pasetka
- Department of Pharmacy Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Frances W Wright
- Department of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Katie Rice
- Department of Social Work, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Fiona McCullock
- Department of Nursing, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | | | - Ewa Szumacher
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada.
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Takeda T, Takeda S, Uryu K, Ichihashi Y, Harada H, Iwase A, Tamura Y, Hibino M, Horiuchi S, Kani H. Multidisciplinary Lung Cancer Tumor Board Connecting Eight General Hospitals in Japan via a High-Security Communication Line. JCO Clin Cancer Inform 2020; 3:1-7. [PMID: 30860865 PMCID: PMC6873933 DOI: 10.1200/cci.18.00115] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The complexity of lung cancer treatment is rapidly increasing, necessitating the use of multidisciplinary approaches for improving outcomes. Although it is common for institutions to have their own tumor boards, tumor boards connecting several general hospitals, and therefore allowing for more diverse opinions, are not prevalent. MATERIALS AND METHODS A tumor board connecting eight hospitals was formed to discuss patients for whom formulating a treatment strategy was difficult. Physicians and hospital staff accessed a high-security communication line via LiveOn ( Japan Media Systems Corporation, Tokyo, Japan), which is completely isolated from the Internet and password protected, that enables each hospital to share the electronic medical records and images of relevant patients at other hospitals on desktop computers in real time. The lung cancer tumor board began in April 2017 and has since been held every Tuesday evening for 1 hour. Preparatory records containing the age, sex, histology, TNM classification, background, and discussion points for each patient are created before each tumor board meeting. After the tumor board discussion, all conclusions and related articles used in the board are added to the minutes, which are finalized as Microsoft Word files, consolidated, and archived. These files can be retrieved later using key words. RESULTS From April 2017 to June 2018, 202 patients were discussed. Although TNM classification was not changed for any patient, diverse opinions led to a change in the proposed strategy for 49 of 202 patients. CONCLUSION The multidisciplinary tumor board was useful in obtaining various opinions from the perspectives of different experts. This should be evaluated in a prospective study.
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Affiliation(s)
| | | | | | | | | | | | | | - Makoto Hibino
- Shonan-Fujisawa Tokushukai Hospital, Kanagawa, Japan
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8
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Biganzoli L, Cardoso F, Beishon M, Cameron D, Cataliotti L, Coles CE, Delgado Bolton RC, Trill MD, Erdem S, Fjell M, Geiss R, Goossens M, Kuhl C, Marotti L, Naredi P, Oberst S, Palussière J, Ponti A, Rosselli Del Turco M, Rubio IT, Sapino A, Senkus-Konefka E, Skelin M, Sousa B, Saarto T, Costa A, Poortmans P. The requirements of a specialist breast centre. Breast 2020; 51:65-84. [PMID: 32217457 PMCID: PMC7375681 DOI: 10.1016/j.breast.2020.02.003] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/15/2022] Open
Abstract
This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ESMO. To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
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Affiliation(s)
- Laura Biganzoli
- European Society of Breast Cancer Specialists (EUSOMA); Breast Centre, AUSL Toscana Centro, Prato, Italy.
| | - Fatima Cardoso
- European Society of Medical Oncology (ESMO); Breast Unit, Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal
| | | | - David Cameron
- European Cancer Concord (ECC); University of Edinburgh Cancer Centre, IGMM, Western General Hospital, Edinburgh, UK
| | - Luigi Cataliotti
- European Society of Breast Cancer Specialists (EUSOMA), Senonetwork Italia and Breast Centres Certification, Florence, Italy
| | - Charlotte E Coles
- European Society for Radiotherapy and Oncology (ESTRO); University of Cambridge, Cambridge, UK
| | - Roberto C Delgado Bolton
- European Association of Nuclear Medicine (EANM); Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), University of La Rioja, Logroño, La Rioja, Spain
| | - Maria Die Trill
- International Psycho-Oncology Society (IPOS); ATRIUM: Psycho-Oncology & Clinical Psychology, Madrid, Spain
| | - Sema Erdem
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); Europa Donna, Milan, Italy
| | - Maria Fjell
- European Oncology Nursing Society (EONS); Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Romain Geiss
- International Society of Geriatric Oncology (SIOG); Medical Oncology, Hôpital René Huguenin - Institut Curie, St. Cloud, France
| | - Mathijs Goossens
- European Cancer League (ECL); Centre for Cancer Detection (CvKO), Brussels, Belgium
| | - Christiane Kuhl
- European Society of Radiology (ESR); Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | - Peter Naredi
- European Cancer Organisation (ECCO); Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Simon Oberst
- Organisation of European Cancer Institutes (OECI); Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Jean Palussière
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Department of Imaging, Institut Bergonié, Bordeaux, France
| | - Antonio Ponti
- European Society of Breast Cancer Specialists (EUSOMA), Centre for Epidemiology and Prevention in Oncology (CPO) Piemonte, AOU Citta' Della Salute e Della Scienza, Turin, Italy
| | | | - Isabel T Rubio
- European Society of Surgical Oncology (ESSO); Breast Surgical Oncology, Clinica Universidad de Navarra Madrid, Spain
| | - Anna Sapino
- European Society of Pathology (ESP); Department of Medical Sciences, University of Turin, Turin, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Elzbieta Senkus-Konefka
- European Organisation for Research and Treatment of Cancer (EORTC); Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Marko Skelin
- European Society of Oncology Pharmacy (ESOP); Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Berta Sousa
- European Society of Oncology Pharmacy (ESOP); Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Tiina Saarto
- Flims Alumni Club (FAC); Breast Unit, Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal
| | | | - Philip Poortmans
- Iridium Kankernetwerk, University of Antwerp, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Wilrijk-Antwerp, Belgium
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Biganzoli L, Marotti L, Cardoso MJ, Cataliotti L, Curigliano G, Cuzick J, Goldhirsch A, Leidenius M, Mansel R, Markopoulos C, Wyld L, Rubio IT. European Guidelines on the Organisation of Breast Centres and Voluntary Certification Processes. Breast Care (Basel) 2019; 14:359-365. [PMID: 31933581 PMCID: PMC6940462 DOI: 10.1159/000503603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 09/22/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND EUSOMA undertook the commitment of defining the requirements for a specialist breast centre, which has become the reference document for the implementation of breast centres. SUMMARY The EUSOMA requirements for a specialist breast centre give clear indications regarding the requisite caseload, dedicated team composition (core and non-core team), organisation, availability of services and equipment throughout the patient pathway, quality control, and application of a multidisciplinary approach. The minimum number of cases is 150 newly diagnosed breast cancer cases per year. Based on the EUSOMA requirements, a voluntary and accredited certification scheme has been developed. In Europe, other voluntary certification schemes are available, such as those developed by the German Cancer Society and German Society for Breast Disease, the National Cancer Peer Review Programme in the UK, and the "label de qualité" established by the Swiss Anticancer League and the Swiss Senology Society. The European Commission Initiative on Breast Cancer (ECIBC) has overseen the development of a European Quality Assurance Scheme. KEY MESSAGES Nearly 20 years after the initial publication of the EUSOMA requirements, ensuring that all breast cancer patients in Europe are treated only in certified breast centres should be considered a high priority and eventually achieved through collaborative efforts.
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Affiliation(s)
| | | | - Maria-Joao Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Nova Medical School, Lisbon, Portugal
| | | | - Giuseppe Curigliano
- Department of Oncology and Haematology, University of Milan, Milan, Italy
- IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Jack Cuzick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Aaron Goldhirsch
- International Breast Cancer Study Group, Bern, Switzerland
- MultiMedica, Milan, Italy
| | - Marjut Leidenius
- Breast Surgery Unit, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Robert Mansel
- Cardiff University School of Medicine, Cardiff, United Kingdom
| | | | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, United Kingdom
| | - Isabel T. Rubio
- Breast Surgical Oncology Unit, Clinica Universidad de Navarra, Madrid, Spain
- Universidad de Navarra, Pamplona, Spain
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AlFarhan HA, Algwaiz GF, Alzahrani HA, Alsuhaibani RS, Alolayan A, Abdelhafiz N, Ali Y, Boghdadly S, Jazieh AR. Impact of GI Tumor Board on Patient Management and Adherence to Guidelines. J Glob Oncol 2019; 4:1-8. [PMID: 30241257 PMCID: PMC6223466 DOI: 10.1200/jgo.17.00164] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose As the burden of cancer on the population and the health care system continues to increase with more complicated treatment options, the need for multidisciplinary teams to be as efficient as possible becomes more vital. Our study aimed to evaluate the consistency of GI Tumor Board (GI TB) recommendations with international guidelines, the adherence of physicians involved in patient care to TB recommendations, and the impact on the management of patients. Methods A prospective cohort study was conducted from January to June 2016 at our institution, which is a major tertiary hospital that provides comprehensive cancer care. All cases presented at the GI TB during this period were included. Data regarding adherence to National Comprehensive Cancer Network guidelines, adherence to TB recommendations, and changes made to the management of patients were collected weekly from the GI TB in a data collection form. Results Of the 104 patients included, 57 (55%) were males and the median age was 58 (16 to 85) years. Colorectal cancer was the most common diagnosis, in 65 patients (63%). Nearly one-half of cases (45%) were stage IV cancers. Starting new treatment was recommended for 72 patients (69%). Further investigations were requested for 15 patients (14%). For imaging, 24 recommendations (23%) were made. Adherence to National Comprehensive Cancer Network guidelines was observed in 97% of total recommendations. New findings were found in pathology (11%), radiology (13%), and staging (4%). Management plans were changed in 37 cases (36%). Over a 3-month period after presentation to the GI TB, most of the recommendations (87%) were performed. Conclusion A multidisciplinary tumor board enhances the adherence to guidelines and has an impact on patient management in approximately one-third of patients. Among physicians, adherence to recommendations of the TB was high.
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Affiliation(s)
- Haneen A AlFarhan
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ghada F Algwaiz
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hajer A Alzahrani
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Roaa S Alsuhaibani
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ashwaq Alolayan
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nafisa Abdelhafiz
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Yosra Ali
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sami Boghdadly
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdul Rahman Jazieh
- Haneen A. AlFarhan, Ghada F. Algwaiz, Hajer A. Alzahrani, and Roaa S. Alsuhaibani, King Saud bin Abdulaziz University for Health Sciences; Ashwaq Alolayan, Nafisa Abdelhafiz, Yosra Ali, Sami Boghdadly, and Abdul Rahman Jazieh, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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11
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Shao J, Rodrigues M, Corter AL, Baxter NN. Multidisciplinary care of breast cancer patients: a scoping review of multidisciplinary styles, processes, and outcomes. Curr Oncol 2019; 26:e385-e397. [PMID: 31285683 PMCID: PMC6588064 DOI: 10.3747/co.26.4713] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Clinical practice guidelines recommend a multidisciplinary approach to cancer care that brings together all relevant disciplines to discuss optimal disease management. However, the literature is characterized by heterogeneous definitions and few reviews about the processes and outcomes of multidisciplinary care. The objective of this scoping review was to identify and classify the definitions and characteristics of multidisciplinary care, as well as outcomes and interventions for patients with breast cancer. Methods A systematic search for quantitative and qualitative studies about multidisciplinary care for patients with breast cancer was conducted for January 2001 to December 2017 in the following electronic databases: medline, embase, PsycInfo, and cinahl. Two reviewers independently applied our eligibility criteria at level 1 (title/abstract) and level 2 (full-text) screening. Data were extracted and synthesized descriptively. Results The search yielded 9537 unique results, of which 191 were included in the final analysis. Two main types of multidisciplinary care were identified: conferences and clinics. Most studies focused on outcomes of multidisciplinary care that could be variously grouped at the patient, provider, and system levels. Research into processes tended to focus on processes that facilitate implementation: team-working, meeting logistics, infrastructure, quality audit, and barriers and facilitators. Summary Approaches to multidisciplinary care using conferences and clinics are well described. However, studies vary by design, clinical context, patient population, and study outcome. The heterogeneity of the literature, including the patient populations studied, warrants further specification of multidisciplinary care practice and systematic reviews of the processes or contexts that make the implementation and operation of multidisciplinary care effective.
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Affiliation(s)
- J Shao
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - M Rodrigues
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - A L Corter
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - N N Baxter
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
- Department of Surgery, St. Michael's Hospital, Toronto, ON
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON
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12
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Ntalos D, Berger-Groch J, Rohde H, Grossterlinden LG, Both A, Luebke A, Hartel MJ, Klatte TO. Implementation of a multidisciplinary infections conference affects the treatment plan in prosthetic joint infections of the hip: a retrospective study. Arch Orthop Trauma Surg 2019; 139:467-473. [PMID: 30488282 DOI: 10.1007/s00402-018-3079-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Establishing a systematic multidisciplinary approach in the treatment of prosthetic joint infections (PJI) of the hip and analyzing its effect on clinical decision-making. PATIENTS AND METHODS Forty-six patients diagnosed with PJI of the hip were included in the retrospective study. The treatment plan was either established by a single-discipline approach (n = 20) or by a weekly multidisciplinary infections conference (n = 26) consisting of at least an orthopedic surgeon, microbiologist and pathologist. Recorded data included the length of hospital stay, number and type of surgeries, medical complications, recovered organisms as well as the number of applied antibiotics. RESULTS Patients discussed in the multidisciplinary infections conference showed a significantly shorter in-hospital stay (29 vs 62 days; p < 0.05), a significant reduction in surgeries (1.8 vs 5.1; p < 0.05) and a smaller number of antibiotics required (2.8 vs 4.2; p < 0.05). No significant difference could be found comparing inpatient complications between the two groups. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently recovered organisms in both patient groups. CONCLUSION This study demonstrates the successful implementation of a weekly infections conference as an instrument to introduce a multidisciplinary approach to PJI of the hip. Implementation of these conferences significantly improves the treatment plan compared to a single-discipline approach, which we therefore highly recommend for other institutions. Multidiscipline may even affect clinical outcome which needs to be further investigated.
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Affiliation(s)
- Dimitris Ntalos
- Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - J Berger-Groch
- Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - H Rohde
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L G Grossterlinden
- Department of Orthopaedic, Trauma and Spine Surgery, Asklepios Hospital Altona, Hamburg, Germany
| | - A Both
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M J Hartel
- Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - T O Klatte
- Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Vest JR, Caine V, Harris LE, Watson DP, Menachemi N, Halverson P. Fostering Local Health Department and Health System Collaboration Through Case Conferences for At-Risk and Vulnerable Populations. Am J Public Health 2018; 108:649-651. [PMID: 29565669 DOI: 10.2105/ajph.2018.304345] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In case conferences, health care providers work together to identify and address patients' complex social and medical needs. Public health nurses from the local health department joined case conference teams at federally qualified health center primary care sites to foster cross-sector collaboration, integration, and mutual learning. Public health nurse participation resulted in frequent referrals to local health department services, greater awareness of public health capabilities, and potential policy interventions to address social determinants of health.
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Affiliation(s)
- Joshua R Vest
- Joshua R. Vest, Dennis P. Watson, Nir Menachemi, and Paul Halverson are with the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis. Virginia Caine is with the Marion County Public Health Department, Indianapolis. Lisa E. Harris is with Eskenazi Health, Indianapolis
| | - Virginia Caine
- Joshua R. Vest, Dennis P. Watson, Nir Menachemi, and Paul Halverson are with the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis. Virginia Caine is with the Marion County Public Health Department, Indianapolis. Lisa E. Harris is with Eskenazi Health, Indianapolis
| | - Lisa E Harris
- Joshua R. Vest, Dennis P. Watson, Nir Menachemi, and Paul Halverson are with the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis. Virginia Caine is with the Marion County Public Health Department, Indianapolis. Lisa E. Harris is with Eskenazi Health, Indianapolis
| | - Dennis P Watson
- Joshua R. Vest, Dennis P. Watson, Nir Menachemi, and Paul Halverson are with the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis. Virginia Caine is with the Marion County Public Health Department, Indianapolis. Lisa E. Harris is with Eskenazi Health, Indianapolis
| | - Nir Menachemi
- Joshua R. Vest, Dennis P. Watson, Nir Menachemi, and Paul Halverson are with the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis. Virginia Caine is with the Marion County Public Health Department, Indianapolis. Lisa E. Harris is with Eskenazi Health, Indianapolis
| | - Paul Halverson
- Joshua R. Vest, Dennis P. Watson, Nir Menachemi, and Paul Halverson are with the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis. Virginia Caine is with the Marion County Public Health Department, Indianapolis. Lisa E. Harris is with Eskenazi Health, Indianapolis
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Horlait M, Van Belle S, Leys M. Input of Psychosocial Information During Multidisciplinary Team Meetings at Medical Oncology Departments: Protocol for an Observational Study. JMIR Res Protoc 2018; 7:e64. [PMID: 29483068 PMCID: PMC5847814 DOI: 10.2196/resprot.9239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/04/2017] [Accepted: 12/16/2017] [Indexed: 12/18/2022] Open
Abstract
Background Multidisciplinary team meetings (MDTMs) have become standard practice in oncology and gained the status of the key decision-making forum for cancer patient management. The current literature provides evidence that MDTMs are achieving their intended objectives but there are also indications to question the positive impact of MDTMs in oncology settings. For cancer management to be patient-centered, it is crucial that medical information as well as psychosocial aspects—such as the patients’ living situation, possible family problems, patients' mental state, and patients’ perceptions and values or preferences towards treatment or care—are considered and discussed during MDTMs. Previous studies demonstrate that failure to account for patients’ psychosocial information has a negative impact on the implementation of the treatment recommendations formulated during MDTMs. Few empirical studies have demonstrated the predominant role of physicians during MDTMs, leading to the phenomenon that medical information is shared almost exclusively at the expense of psychosocial information. However, more in-depth insight on the underlying reasons why MDTMs fail to take into account psychosocial information of cancer patients is needed. Objective This paper presents a research protocol for a cross-sectional observational study that will focus on exploring the barriers to considering psychosocial information during MDTMs at medical oncology departments. Methods This protocol encompasses a cross-sectional comparative case study of MDTMs at medical oncology departments in Flanders, Belgium. MDTMs from various oncology subspecialties at inpatient medical oncology departments in multiple hospitals (academic as well as general hospitals) are compared. The observations focus on the “multidisciplinary oncology consultation” (MOC), a formally regulated and financed type of MDTM in Belgian oncology since 2003. Data are collected through nonparticipant observations of MOC–meetings. Observational data are supplemented with semi-structured individual interviews with members of the MOC–meetings. Results The protocol is part of a larger research project on communication and multidisciplinary collaboration in oncology departments. Results of this study will particularly focus on the input of psychosocial information during MDTMs. Conclusions The concept of an MDTM should not merely be a group of care professionals who mostly work independently and occasionally liaise with one another. Interventions aiming to enhance the input of psychosocial information are crucial to ensure that MDTMs can benefit from their diverse membership to achieve their full potential. The findings from this study can be used to design nonclinical and organizational interventions that enhance multidisciplinary decision-making in oncology.
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Affiliation(s)
- Melissa Horlait
- Organisation, Policy and Social Inequalities in Health Care, Department of Health Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Simon Van Belle
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Mark Leys
- Organisation, Policy and Social Inequalities in Health Care, Department of Health Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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