Multidisciplinary cancer care: Does it improve outcomes?

Brar, Savtaj; Hong, Nicole Look; Wright, Frances C.

doi:10.1002/jso.23700

Cited by 75 publications

(42 citation statements)

References 55 publications

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“…Identifying strategies to improve adherence to colon cancer screening guidelines to limit the number of nonelective colon cancer resections, increase the rate of a minimally invasive approach, and either increase resource availability or develop a standardised algorithm to select patients for CGA and prehabilitation may further improve outcomes for older patients. Given that cardiovascular disease was the second-leading cause of 1-year mortality following colon cancer surgery, CGA, multidisciplinary care, and management of patient comorbidities among surgeons, primary care physicians, and medical oncologists may further help improve patient survival (Kim et al, 2010;Brar et al, 2014). Because 66% of the study cohort had stage I or II colon cancer, it is plausible that the majority of patients never saw a medical oncologist following surgery.…”

Section: Discussionmentioning

confidence: 99%

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Aquina

Mohile

Tejani

et al. 2016

JCO

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Section: Discussionmentioning

confidence: 99%

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Aquina

Mohile

Tejani

et al. 2016

JCO

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“…Cancer management requires coordinated delivery of services by different professionals, in different settings and at different time points (Brar, Look Hong, & Wright, 2014). Multidisciplinary teamwork (MDT) improves clinical and patient‐reported outcomes for cancer by improving treatment decisions, and their implementation and documentation; attendance and professional diversity at joint meetings; role clarity among team members; team effectiveness and staff satisfaction; and guideline‐adherent care delivery (Fleissig, Jenkins, Catt, & Fallowfield, 2006; Lamb et al., 2011; Lemieux‐Charles & McGuire, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…MDT is frequently operationalised through multidisciplinary cancer conferences (MCCs) which improve cancer management and associated outcomes (Hayward et al., 2003; Hong, Wright, Gagliardi, & Paszat, 2010; Taylor, Shewbridge, Harris, & Green, 2013; Wright, De Vito, Langer, & Hunter, 2007). Timely diagnosis of cancer improves access to MCCs, leading to earlier treatment and a potentially better prognosis (Brar et al., 2014). Clinicians whom we surveyed suggested the need to improve MDT earlier in the cancer trajectory given numerous barriers of access to, and coordination of diagnosis (Gagliardi, Wright, Davis, Urbach, & McLeod, 2008).…”

Section: Introductionmentioning

confidence: 99%

How do the characteristics of breast cancer diagnostic assessment programmes influence service delivery: A mixed methods study

et al. 2017

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Diagnostic assessment programmes (DAPs) coordinate multidisciplinary teamwork (MDT), and improve wait times and patient satisfaction. No research has established optimal DAP design. This study explored how DAP characteristics influence service delivery. A mixed methods case study of four breast cancer DAPs was conducted including qualitative interviews with health‐care providers and retrospective chart review. Data were integrated using multiple approaches. Twenty‐three providers were interviewed; 411 medical records were reviewed. The number of visits and wait times from referral to diagnosis and consultation were lowest at a one‐stop model. DAP characteristics (rural–remote region, human resources, referral volume, organisation of services, adherence to service delivery targets and one‐stop model) may influence service delivery (number of visits, wait times). MDT, influenced by other DAP characteristics (co‐location of staff, patient navigators, team functioning), may also influence service delivery. While the one‐stop model may be ideal, all sites experienced similar and unique challenges. Further research is needed to understand how to optimise the organisation and delivery of DAP services. Measures reflecting individual, team and patient‐reported outcomes should be used to assess the effectiveness and impact of DAPs in addition to more traditional measures such as wait times.

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“…Linkage between primary and secondary care, and coordination of multiple procedures and health professionals, is essential to achieve a timely diagnosis, which can potentially be associated with improved cancer outcomes 1,2 . Various factors can delay diagnosis and contribute to poor clinical outcomes and a poor patient experience.…”

Section: Introductionmentioning

confidence: 99%

Cost Analysis of Breast Cancer Diagnostic Assessment Programs

et al. 2017

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Objectives Diagnostic assessment programs (daps) appear to improve the diagnosis of cancer, but evidence of their cost-effectiveness is lacking. Given that no earlier study used secondary financial data to estimate the cost of diagnostic tests in the province of Ontario, we explored how to use secondary financial data to retrieve the cost of key diagnostic test services in daps, and we tested the reliability of that cost-retrieving method with hospital-reported costs in preparation for future cost-effectiveness studies.Methods We powered our sample at an alpha of 0.05, a power of 80%, and a margin of error of ±5%, and randomly selected a sample of eligible patients referred to a dap for suspected breast cancer during 1 January-31 December 2012. Confirmatory diagnostic tests received by each patient were identified in medical records. Canadian Classification of Health Intervention procedure codes were used to search the secondary financial data Web portal at the Ontario Case Costing Initiative for an estimate of the direct, indirect, and total costs of each test. The hospital-reported cost of each test received was obtained from the host-hospital's finance department. Descriptive statistics were used to calculate the cost of individual or group confirmatory diagnostic tests, and the Wilcoxon signed-rank test or the paired t-test was used to compare the Ontario Case Costing Initiative and hospital-reported costs. ResultsFor the 191 identified patients with suspected breast cancer, the estimated total cost of $72,195.50 was not significantly different from the hospital-reported total cost of $72,035.52 (p = 0.24). Costs differed significantly when multiple tests to confirm the diagnosis were completed during one patient visit and when confirmatory tests reported in hospital data and in medical records were discrepant. The additional estimated cost for non-salaried physicians delivering diagnostic services was $28,387.50. ConclusionsIt was feasible to use secondary financial data to retrieve the cost of key diagnostic tests in a breast cancer dap and to compare the reliability of the costs obtained by that estimation method with hospital-reported costs. We identified the strengths and challenges of each approach. Lessons learned from this study have to be taken into consideration in future cost-effectiveness studies.

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Multidisciplinary cancer care: Does it improve outcomes?

Cited by 75 publications

References 55 publications

The impact of age on complications, survival, and cause of death following colon cancer surgery.

The impact of age on complications, survival, and cause of death following colon cancer surgery.

How do the characteristics of breast cancer diagnostic assessment programmes influence service delivery: A mixed methods study

Cost Analysis of Breast Cancer Diagnostic Assessment Programs

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