Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results

Smeltzer, Matthew P.; Rugless, Fedoria; Jackson, Bianca; Berryman, Courtney; Faris, Nicholas R.; Ray, Meredith; Meadows, Meghan; Patel, Anita; Roark, Kristina S.; Kedia, Satish; Debon, Margaret; Crossley, Fayre J.; Oliver, Georgia; McHugh, Laura; W, Hastings; Osborne, Orion; Osborne, Jackie; Ill, Toni; Ill, Mark; Jones, Wynett; Lee, Hyo K.; Signore, Raymond S.; Fox, Roy; Li, Jingshan; Robbins, Edward; Ward, Kenneth D.; Klesges, Lisa M.; Osarogiagbon, Raymond U.

doi:10.21037/tlcr.2018.01.02

Cited by 15 publications

(20 citation statements)

References 12 publications

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“…MDTs, involving close coordination from a range of specialists, including physicians, surgeons, oncologists, pathologists, radiologists, nurses, and allied health care personnel, have become standard of care in lung cancer treatment in many centers around the world. MDT data can provide important information on lung cancer outcomes and on the impact of MDT care, which is associated with a range of clinical benefits as noted above, as well as valuable insights into current practices . Data linkage to other sources can enhance this further .…”

Section: Discussionmentioning

confidence: 98%

“…Multidisciplinary team (MDT) care in lung cancer confers a number of clinical benefits associated with MDT care, including improvement in survival, treatment receipt, modification of treatment plans compared with premeeting plans, accuracy of staging, adherence to international treatment recommendations, and patient‐related outcomes . However, detailed evaluation of the data collected during meetings, which may overlap with but also differ from comprehensive registry data, and how the data are used by MDTs is sparsely reported.…”

Section: Introductionmentioning

confidence: 99%

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Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study

Rankin

Vinod

Nagarajah

et al. 2019

Asia-Pac J Clncl Oncology

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Aim: Multidisciplinary team (MDT) meetings can facilitate optimal lung cancer care, yet details of structured data collection and feedback remain sparse. This study aimed to investigate data collection and the impact of feedback to lung cancer MDTs. Methods:A mixed-methods study using pre and post-test surveys, semistructured interviews, and observation to evaluate data collection and response to modeled data feedback in three Australian lung cancer MDTs at different locations and development stage (site A: outer metropolitan, established; site B, outer metropolitan, new; and site C, inner metropolitan, established). Results: MDT attendees (range 13-25) discussed 5-8 cases per meeting. All sites collected data prospectively (80% prepopulated) into local oncology medical information systems. The pretest survey had 17 respondents in total (88% clinicians). At sites A and C, 100% of respondents noted regular data audits, occasional at site B. Regular audit data included number of cases, stage, final diagnosis, and time to diagnosis and treatment. The post-test survey had 25 respondents in total, all clinicians. The majority (88-96%) of respondents found modeled data easy to interpret, relevant to clinical practice and the MDT, and welcomed future regular data presentations (as rated on a 5-point Likert scale mean weighted average 4.5 where > 4 demonstrates agreement). Semistructured interviews identified five major themes for MDTs: current practice, attitudes, enablers, barriers, and benefits for the MDT.Conclusions: MDT teams exhibited positive responses to modeled data feedback. Key characteristics of MDT data were identified and may assist with future team research and development. K E Y W O R D S data feedback, data quality, health data, lung neoplasm, multidisciplinary teams Asia-Pac J Clin Oncol. 2020;16:45-55. c

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study

Rankin

Vinod

Nagarajah

et al. 2019

Asia-Pac J Clncl Oncology

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“…Patient-centered outcomes, which are as important, if not more so in patients with cancer, are also largely unstudied in thoracic oncology. One preliminary qualitative study has shown high satisfaction with clinic co-location of services for lung cancer patients (11).…”

Section: Measuring Qualitymentioning

confidence: 99%

Measuring the quality of multi-disciplinary thoracic oncology care

2019

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As a result of the rapid acceleration in new treatment advances in thoracic oncology, coordination and tailored selection of treatment modalities has become complex. This increasing complexity mandates multidisciplinary input and coordinated management. However, quality of care in the domain of multidisciplinary thoracic oncology has yet to be purposefully defined, and as a result the science of performance measurement has yet to be applied to this area. In this review we discuss the role of multidisciplinary care in thoracic oncology, and outline its definitions as proposed in the literature. We review various metrics of quality in complex multidisciplinary thoracic oncology care, and future directions for quality and performance measurement.

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“…A multidisciplinary team (MDT) consists of specialists with different backgrounds, skills and clinical experience, working together to recommend the best clinical pathway both in the case of planned treatments or to establish the most appropriate follow-up program [ 2 ]. MDT meetings in oncology can also be defined as tumor boards (TB); they offer several clinical benefits for global care: overall survival improvement [ 3 , 4 ], receipt of therapy [ 5 , 6 ], optimizing of treatment plan compared with pre-MDT hypotheses [ 7 , 8 ], staging accuracy [ 9 ] and global adherence to guidelines and international evidence-based recommendations [ 10 , 11 , 12 , 13 ].The MDT meeting can be considered as a common platform to coordinate the delivery of care by merging different clinical expertise in a single setting and can therefore be defined as a regularly scheduled discussion of clinical cases with the participation of physicians from different specialties such as surgeons, oncologists, radiotherapists, pulmonologists, pathologists, anesthesiologists, nurse specialists and other specialists when needed [ 14 ]. MDT meetings are suggested by many lung cancer treatment guidelines [ 15 , 16 , 17 ] but their organization and management is quite heterogeneous, varying across countries, hospitals and departments.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Multidisciplinary Team Meetings on Patient Management in Oncologic Thoracic Surgery: A Single-Center Experience

Petrella

Radice

Guarize

et al. 2021

Cancers

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Background: the aim of this paper is to quantify multidisciplinary team meeting (MDT) impact on the decisional clinical pathway of thoracic cancer patients, assessing the modification rate of the initial out-patient evaluation. Methods: the impact of MDT was classified as follows: confirmation: same conclusions as out-patient hypothesis; modification: change of out-patient hypothesis; implementation: definition of a clear clinical track/conclusion for patients that did not receive any clinical hypothesis; further exams required: the findings that emerged in the MDT meeting require further exams. Results: one thousand consecutive patients evaluated at MDT meetings were enrolled. Clinical settings of patients were: early stage lung cancer (17.4%); locally advanced lung cancer (27.4%); stage IV lung cancer (9.8%); mesothelioma (1%); metastases to the lung from other primary tumors (4%); histologically proven or suspected recurrence from previous lung cancer (15%); solitary pulmonary nodule (19.2%); mediastinal tumors (3.4%); other settings (2.8%). Conclusions: MDT meetings impact patient management in oncologic thoracic surgery by modifying the out-patient clinical hypothesis in 10.6% of cases; the clinical settings with the highest decisional modification rates are “solitary pulmonary nodule” and “proven or suspected recurrence” with modification rates of 14.6% and 13.3%, respectively.

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Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results

Abstract: This study demonstrates a comprehensive implementation of a multidisciplinary model of lung cancer care, which will advance the science behind implementing this much-advocated clinical care model.

Cited by 15 publications

References 12 publications

Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study

Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study

Measuring the quality of multi-disciplinary thoracic oncology care

The Impact of Multidisciplinary Team Meetings on Patient Management in Oncologic Thoracic Surgery: A Single-Center Experience

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