Implementing a Multidisciplinary Tumor Board in the Community Practice Setting

Lesslie, Michele D.; Parikh, Jay R.

doi:10.3390/diagnostics7040055

Cited by 42 publications

(38 citation statements)

References 23 publications

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“…A MDT is a team composed of professionals from different clinical specialties who work together to make decisions about the recommended clinical pathway of an individual patient [2,3]. MDT meetings are a fundamental part of a complex care path, during which MDTs gather to discuss on a series of patients in order to achieve a definite staging and formulate a shared treatment plan, in the light of the best available evidence for customized treatment options and appropriate followup.…”

Section: Introductionmentioning

confidence: 99%

“…When MDT meetings are focused on oncological patient's care, they are called Tumor Boards (TBs) [3]. They could also be addressed as Multidisciplinary Cancer Conferences (MCC), which have been defined by Wright et al, 2007 as forum for healthcare providers aiming to discuss diagnostic and treatment of cancer patients [6].…”

Section: Introductionmentioning

confidence: 99%

“…Cancer patients can be discussed either in a prospective or retrospective manner. A TB with a prospective approach gathers the collaborating specialists formally at scheduled times in order to review individual cancer patients in a pragmatic way using an evidence-based approach, to discuss diagnosis and formulate future treatment and management plans [3].…”

Section: Introductionmentioning

confidence: 99%

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The impact of tumor board on cancer care: evidence from an umbrella review

Specchia

Frisicale

Carini

et al. 2020

BMC Health Serv Res

153

146

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Background: Tumor Boards (TBs) are Multidisciplinary Team (MDT) meetings in which different specialists work together closely sharing clinical decisions in cancer care. The composition is variable, depending on the type of tumor discussed. As an organizational tool, MDTs are thought to optimize patient outcomes and to improve care performance. The aim of the study was to perform an umbrella review summarizing the available evidence on the impact of TBs on healthcare outcomes and processes. Methods: Pubmed and Web of Science databases were investigated along with a search through citations. The only study design included was systematic review. Only reviews published after 1997 concerning TBs and performed in hospital settings were considered. Two researchers synthetized the studies and assessed their quality through the AMSTAR2 tool. Results: Five systematic reviews published between 2008 and 2017 were retrieved. One review was focused on gastrointestinal cancers and included 16 studies; another one was centered on lung cancer and included 16 studies; the remaining three studies considered a wide range of tumors and included 27, 37 and 51 studies each. The main characteristics about format and members and the definition of TBs were collected. The decisions taken during TBs led to changes in diagnosis (probability to receive a more accurate assessment and staging), treatment (usually more appropriate) and survival (not unanimous improvement shown). Other outcomes less highlighted were quality of life, satisfaction and waiting times. Conclusions: The study showed that the multidisciplinary approach is the best way to deliver the complex care needed by cancer patients; however, it is a challenge that requires organizational and cultural changes and must be led by competent health managers who can improve teamwork within their organizations. Further studies are needed to reinforce existing literature concerning health outcomes. Evidence on the impact of TBs on clinical practices is still lacking for many aspects of cancer care. Further studies should aim to evaluate the impact on survival rates, quality of life and patient satisfaction. Regular studies should be carried out and new process indicators should be defined to assess the impact and the performance of TBs more consistently.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of tumor board on cancer care: evidence from an umbrella review

Specchia

Frisicale

Carini

et al. 2020

BMC Health Serv Res

153

146

View full text Add to dashboard Cite

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“…ultidisciplinary conferences (MDCs) are an increasing part of radiologists' workflow not only at major academic and tertiary referral centers but also in the community setting (1). The American College of Surgeons first established the Commission on Cancer accreditation program to provide standards for the establishment of MDCs (2).…”

mentioning

confidence: 99%

Prospective Analysis of Radiology Resource Utilization and Outcomes for Participation in Oncology Multidisciplinary Conferences

et al. 2021

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Rationale and Objectives: Radiology participation is necessary in oncology multidisciplinary conferences (MDCs), but the resources required to do so are often unaccounted for. In this prospective study we provide an analysis of resource utilization as a function of outcomes for all MDCs covered by an entire radiology section and provide a time-based cost estimate. Materials and Methods: Following institutional review board approval, prospective data on all MDCs covered by abdominal radiologists at a single tertiary care academic center were obtained over nine weeks. A predefined questionnaire was used by a single observer who attended every imaging review and recorded the total time spent by the radiologists and several outcome measures. The total time recorded was used to provide a time-based cost estimate using a national salary survey. Results: Six radiologists participated in a total of 57 MDCs, with 577 cases reviewed and discussed. 181 (31%) cases were performed at outside facilities requiring full reinterpretation. Clinically significant revisions to original reports were recorded in 107 (18.5%) cases. Radiologist input directly resulted in alteration of cancer staging in 65 (11%) patients and specific recommendations for follow-up diagnostic workup in 280 (48%) of cases. The mean total time devoted by the staff radiologist per week to MDCs was 18.7 hours/week, nearly a half of full-time effort, or 8% of total effort per radiologist. The total annual projected cost of radiology coverage for each weekly MDC was $26,920. Conclusion: Section-wide radiologist participation in MDCs directly resulted in change in clinical management in nearly half of reviewed cases. This was achieved at a notable time cost, highlighting the need for efficient integration of radiology MDC participation into radiologist workflow and compensation models.

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“…According to the recent literature, our study shows that MTB seems to improve the quality of care and increase the survival in the oncologic patients (Lee et al, 2017;Lesslie & Parikh, 2017;MacDermid et al, 2009).…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 62%