• Breast Neoplasms
• Patient Care Team
• Progression-Free Survival
• Survival Analysis

• 82172873 National Natural Science Foundation of China
• ZR2021QH002 Natural Science Foundation of Shandong Province
• tsqn202211337 Taishan Scholars Program of Shandong Province

• Group decision making
• Groupthink
• Medical education

• Ageing
• Attitudes
• Decision making
• Health communication
• Neoplasms

• Humans
• Attitude of Health Personnel
• Neoplasms/therapy
• Aged
• Health Personnel/psychology
• Clinical Decision-Making
• Decision Making

• multi-disciplinary team
• oncology
• patient centred care
• patient preferences
• person centred care
• treatment decision-making

• Dutch Cancer Society

• cancer
• clinical governance
• dissent and disputes
• humans
• neoplasms
• patient care team
• policy
• surveys and questionnaires

• Humans
• Dissent and Disputes
• Incidence
• Patient Care Team
• Neoplasms/epidemiology
• Neoplasms/therapy
• Surveys and Questionnaires

• mixed reality
• software platform
• tumour board

• 005-01903-0047 Ministry of Economic Affairs, Innovation, Digitalization and Energy of the State of North Rhine-Westphalia (MWIDE NRW)

• Collaborative clinical reasoning
• Health professions
• Scoping
• Shared mental

• Humans
• Problem Solving
• Delivery of Health Care
• Health Personnel
• Decision Making, Shared
• Clinical Reasoning

• aged
• clinical decision-making
• oncology
• physicians
• protocols & guidelines

• Aged
• Humans
• Attitude of Health Personnel
• Clinical Decision-Making
• Delivery of Health Care
• Frailty/therapy
• Neoplasms/therapy
• Research Design
• Scoping Reviews As Topic

• Luxembourg National Research Fund (FNR)

• Complications
• Cost-effectiveness
• Costs
• Frailty
• Health technology assessment
• High-risk
• Mortality
• Patient’s preferences
• Preoperative multidisciplinary team
• Quality of life
• Risk tools
• Serious adverse events
• Stepped-wedge randomized cluster design

• Humans
• Adult
• Quality of Life
• Medicine
• Perioperative Care
• Hospitals
• Patient Care Team

• 10330032010003 ZonMw

• Humans
• Orthopedics
• Prospective Studies
• Radiography
• Diagnostic Imaging
• Radiology

• Humans
• Pilot Projects
• Patient Care Team
• Decision Making
• Neoplasms/diagnosis
• Neoplasms/therapy
• Medical Oncology

• compliance
• gynecological cancers
• multidisciplinary tumor boards

• Humans
• Genital Neoplasms, Female/therapy
• Female
• Guideline Adherence
• Outcome Assessment, Health Care
• Retrospective Studies
• Adult
• Middle Aged
• Aged
• Aged, 80 and over

• multi-professional tumor boards
• pathology
• radio-oncology
• radiology
• specialized palliative care

This study reports early mortality and survival from colorectal cancer in relation to the pattern of treatments delivered by the multidisciplinary team (MDT) meeting at a high-volume institution in England over 14 years.

All patients diagnosed with colorectal cancer and discussed during MDT meetings from 2003 to 2016 at a single institution were reviewed. Three time intervals (2003–2007, 2008–2012, and 2013–2016) were compared regarding initial surgical management (resection, local excision, non-resection surgery, and no surgery), initial oncological therapy, 90-day mortality, and crude 2-year survival for the whole cohort. Sub-analyses were performed according to age greater or less than 80 years.

The MDT managed 4617 patients over 14 years (1496 in the first interval and 1389 in the last). Over this time, there was a reduction in emergency resections from 15.5 per cent to 9.0 per cent (P < 0.0001); use of oncological therapies increased from 34.6 per cent to 41.6 per cent (P < 0.0001). The 90-day mortality after diagnosis of colorectal cancer dropped from 14.8 per cent to 10.7 per cent (P < 0.001) and 2-year survival improved from 58.6 per cent to 65 per cent (P < 0.001). Among patients aged 80 years or older (425 and 446, in the first and last intervals respectively) there was, in addition, a progressive increase in ‘no surgery’ rate from 33.6 per cent to 50.2 per cent (P < 0.0001) and a reduction in elective resections from 42.4 per cent to 33.9 per cent (P = 0.010). The 90-day mortality after elective resection fell from 10.0 per cent (18 of 180) to 3.3 per cent (5 of 151; P = 0.013).

Survival from colorectal cancer improved significantly over 14 years. Among patients aged ≥80 years, major changes in the type of treatment delivered were associated with a decrease in postoperative mortality.

Discussing patients with cancer in a multidisciplinary team meeting (MDTM) is customary in cancer care worldwide and requires a significant investment in terms of funding and time. Efficient collaboration and communication between healthcare providers in all the specialisms involved is therefore crucial. However, evidence-based criteria that can guarantee high-quality functioning on the part of MDTMs are lacking. In this systematic review, we examine the factors influencing the MDTMs’ efficiency, functioning and quality, and offer recommendations for improvement.

Relevant studies were identified by searching Medline, EMBASE, and PsycINFO databases (01–01-1990 to 09–11-2021), using different descriptions of ‘MDTM’ and ‘neoplasm’ as search terms. Inclusion criteria were: quality of MDTM, functioning of MDTM, framework and execution of MDTM, decision-making process, education, patient advocacy, patient involvement and evaluation tools. Full text assessment was performed by two individual authors and checked by a third author.

Seventy-four articles met the inclusion criteria and five themes were identified: 1) MDTM characteristics and logistics, 2) team culture, 3) decision making, 4) education, and 5) evaluation and data collection. The quality of MDTMs improves when the meeting is scheduled, structured, prepared and attended by all core members, guided by a qualified chairperson and supported by an administrator. An appropriate amount of time per case needs to be established and streamlining of cases (i.e. discussing a predefined selection of cases rather than discussing every case) might be a way to achieve this. Patient centeredness contributes to correct diagnosis and decision making. While physicians are cautious about patients participating in their own MDTM, the majority of patients report feeling better informed without experiencing increased anxiety. Attendance at MDTMs results in closer working relationships between physicians and provides some medico-legal protection. To ensure well-functioning MDTMs in the future, junior physicians should play a prominent role in the decision-making process. Several evaluation tools have been developed to assess the functioning of MDTMs.

MDTMs would benefit from a more structured meeting, attendance of core members and especially the attending physician, streamlining of cases and structured evaluation. Patient centeredness, personal competences of MDTM participants and education are not given sufficient attention.

The online version contains supplementary material available at 10.1186/s12913-022-08112-0.

• cancer
• multidisciplinary team meeting
• patient assessment
• patient management
• patient outcomes

• no funding to report

MDT discussion is the gold standard for cancer care in the UK. With the incidence of cancer on the rise, demand for MDT discussion is increasing. The need for efficiency, whilst maintaining high standards, is therefore clear. Paper-based MDT quality assessment tools and discussion checklists may represent a practical method of monitoring and improving MDT practice. This reviews aims to describe and appraise these tools, as well as consider their value to quality improvement.

Medline, EMBASE and PsycInfo were searched using pre-defined terms. The PRISMA model was followed throughout. Studies were included if they described the development of a relevant tool, or if an element of the methodology further informed tool quality assessment. To investigate efficacy, studies using a tool as a method of quality improvement in MDT practice were also included. Study quality was appraised using the COSMIN risk of bias checklist or the Newcastle-Ottawa scale, depending on study type.

The search returned 7930 results. 18 studies were included. In total 7 tools were identified. Overall, methodological quality in tool development was adequate to very good for assessed aspects of validity and reliability. Clinician feedback was positive. In one study, the introduction of a discussion checklist improved MDT ability to reach a decision from 82.2 to 92.7%. Improvement was also noted in the quality of information presented and the quality of teamwork.

Several tools for assessment and guidance of MDTs are available. Although limited, current evidence indicates sufficient rigour in their development and their potential for quality improvement.

PROSPERO ID: CRD42021234326.

The online version contains supplementary material available at 10.1186/s12885-022-09369-8.

• Cancer
• Checklist
• Discussion
• Efficacy
• MDT
• Multidisciplinary team
• Quality assessment
• Tumor board

Understanding of factors that contribute to implementation of effective cancer multidisciplinary team meetings (MDMs) is still limited. Published literature on the effect of teamwork function, leadership roles, decision‐making processes and structural components on the quality of MDMs was reviewed and synthesised.

In this paper, a MEDLINE review (September 2020) was performed to assess clinical decision‐making in the context of MDM discussions.

Twenty‐nine eligible studies were included. Six studies addressed the infrastructural aspects of MDMs. Nine studies used either qualitative or mixed method approach to develop and validate observational tools to assess the quality of MDMs. Seven studies used qualitative approaches to explore the opinions of MDM members on factors that impact on the effectiveness of MDMs. Five studies used validated observational tools to observe and assess the effectiveness of MDMs. One prospective study explored the relationship between quality of information presented at MDMs and ability of MDM members to make clinical decisions. The final study prospectively tested the ability of a multicomponent intervention to improve decision‐making processes within MDMs.

A broad range of factors including teamwork, leadership, case complexity, decision‐making processes and availability of patient information were identified to impact the quality of MDMs. Evidence currently available largely focuses on the development of tools to identify factors in need of improvement to optimise MDMs. Robust research is required to identify the factors that are demonstrated to enhance MDM quality which can then aid the standardisation of how MDMs are conducted.

• cancer
• cancer multidisciplinary team meetings
• decision-making
• patient care team
• teamwork

• Humans
• Kaplan-Meier Estimate
• Patient Care Team
• Prognosis
• Retrospective Studies
• Stomach Neoplasms/therapy

• cancer
• clinical leadership
• multidisciplinary care
• oncology
• quality outcomes

Multidisciplinary care is pivotal in cancer centres and the interaction of all cancer disease specialists in decision making processes is state‐of‐the‐art.

To describe differences of MDTMs by tumour type.

Twelve multidisciplinary team meetings (MDTMs) with participation of different cancer disease specialists at a tertiary hospital were assessed by an exploratory sequential mixed method approach with interviews, observations and a survey to address the following five topics: organisational structure and supporting technology; leadership; teamwork; decision‐making, perceived value and motivation. Thirteen persons with different tumour specialities and levels of seniority were interviewed. The 12 MDTMs were observed twice by uninvolved persons and evaluated by the participating physicians with a survey.

There were no systematic differences between MDTMs for different tumour types with the exception of the non‐disease specific type MDTM, which was the only one for which the organisational structure was not driven by an electronic tool. However, several factors could be identified that generally influenced the functioning of the MDTMs. In particular, the quality of decision‐making was highly dependent on the availability of case‐based information and the presence of relevant cancer disease specialists. Leadership and teamwork were rated as important and were comparable across the MDTM. Team participants' motivation and perceived value of MDTMs was high across all meetings.

MDTM at a single institution did not demonstrate disease specific characteristics. An effective MDTM, irrespective of the tumour type, can be successfully structured by technical means and a chairperson coordinating the interaction of cancer disease specialists to improve the decision‐making process.

• behavioral science
• cancer care
• cancer education
• cancer management

• Best practice
• Evaluation
• Interprofessional education
• Multidisciplinary cancer conference
• Multidisciplinary team
• Quality improvement
• Tumor board

• Humans
• Neoplasms
• Patient Care Team
• Quality Improvement

• Decision-making
• Multidisciplinary teams
• Older patients
• Oncology
• Patient specific information
• Patient view

Evidence-based tools are necessary for scientifically improving the way MTBs work. Such tools are available but can be difficult to use. This study aimed to develop a robust observational assessment tool for use on cancer multidisciplinary tumor boards (MTBs) by health care professionals in everyday practice.

A retrospective cross-sectional observational study was conducted in the United Kingdom from September 2015 to July 2016. Three tumor boards from three teaching hospitals were recruited, with 44 members overall. Six weekly meetings involving 146 consecutive cases were video-recorded and scored using the validated MODe tool. Data were subjected to reliability and validity analysis in the current study to develop a shorter version of the MODe.

Phase 1, a reduction of the original items in the MODe, was achieved through two focus group meetings with expert assessors based on previous research. The 12 original items were reduced to 6 domains, receiving full agreement by the assessors. In phase 2, the six domains were subjected to item reliability, convergent validation, and internal consistency testing against the MODe-Lite global score, the MODe global score, and the items of the MODe. Significant positive correlations were evident across all domains (p < 0.01), indicating good reliability and validity. In phase 3, feasibility and high inter-assessor reliability were achieved by two clinical assessors. Six domains measuring clinical input, holistic input, clinical collaboration, pathology, radiology, and management plan were integrated into MODe-Lite.

As an evidence-based tool for health care professionals in everyday practice, MODe-Lite gives cancer MTBs insight into the way they work and facilitates improvements in practice.

The online version contains supplementary material available at 10.1245/s10434-021-09989-7.

• Adjuvant chemotherapy
• Multidisciplinary pancreatic cancer conference
• Neoadjuvant therapy
• Resectable pancreatic cancer
• Survival outcomes

• added value
• care pathways
• critical pathways (MeSH)
• integrated care
• mixed method evaluation
• multidisciplinary team meetings (MDTM)
• oncology

Background: Multidisciplinary team (MDT) meetings provide treatment recommendations based on available information and collective decision-making in teams with complementary professions, disciplines and skills. We aimed to map ancillary medical and nonmedical patient information during case presentations and case discussions in MDT meetings in cancer care. Methods: Through a nonparticipant, observational approach, we mapped verbal information on medical, nonmedical and patient-related characteristics and classified these based on content. Data were collected from 336 case discussions in three MDTs for neuro-oncology, sarcoma and hepato-biliary cancer. Results: Information on physical status was presented in 48.2% of the case discussions, psychological status in 8.9% and comorbidity in 48.5% of the cases. Nonmedical factors, such as family relations, occupation, country of origin and abode were referred to in 3.6–7.7% of the cases, and patient preferences were reported in 4.2%. Conclusions: Provision of information on comorbidities in half of the cases and on patient characteristics and treatment preferences in <10% of case discussions suggest a need to define data elements and develop reporting standards to support robust MDT decision-making.

• cancer conference
• comorbidity
• decision-making
• occupation
• patient-centered
• tumor board

• Comorbidity
• Humans
• Neoplasms/therapy
• Patient Care Team

• Chairing
• Leadership
• Multidisciplinary team meeting
• Observational study
• Tumor board

• Decision Making/ethics
• Humans
• Leadership
• Neoplasms/therapy
• Patient Care Planning/standards
• Patient Care Team/standards

Multidisciplinary care (MDC) is considered best practice in lung cancer care. Health care services have made significant investments in MDC through the establishment of multidisciplinary team (MDT) meetings. This investment is likely to be sustained in future. It is imperative that MDT meetings are efficient, effective, and sufficiently nimble to introduce new innovations to enable best practice. In this article, we consider the ‘evidence-practice gaps’ in the implementation of lung cancer MDC. These gaps were derived from the recurrent limitations outlined in existing studies and reviews. We address the contributions that implementation science and quality improvement can make to bridge these gaps by increasing translation and improving the uptake of innovations by teams.

• Implementation science
• lung cancer
• multidisciplinary care (MDC)
• quality outcomes

• Multidisciplinary team (MDT)
• adherence
• compliance
• outcomes
• survival
• therapy recommendations

• breast neoplasm
• cancer conference
• checklist
• evaluation
• implementation
• multidisciplinary

• interaction analysis
• measurement
• methods
• team dynamics
• team process

Multidisciplinary team (MDT)-driven cancer care is a mandatory UK national policy, widely used globally. However, few studies have examined how MDT members make decisions as a team. We report a single-centre prospective study on team working within breast cancer MDT.

This was a prospective observational study of 10 breast MDT meetings (MDM). Trained clinical observer scored quality of presented information and disciplinary contribution to case reviews in real time, using a validated tool, namely Metric for the Observation of Decision-Making. Data were analysed to evaluate quality of team working.

Ten MDMs were observed (N = 346 patients). An average of 42 patients were discussed per MDM (range: 29–51) with an average 3 min 20 s (range: 31 s–9 min) dedicated to each patient. Management decision was made in 99% of cases. In terms of contribution to case reviews, breast care nurses scored significantly (p < 0.05) lower (M = 1.79, SD = 0.12) compared to other team members (e.g. surgeons, M = 4.65; oncologists, M = 3.07; pathologists, M = 4.51; radiologists, M = 3.21). Information on patient psychosocial aspects (M = 1.69, SD = 0.68), comorbidities (M = 1.36, SD = 0.39) and views on treatment options (M = 1.47, SD = 0.34) was also significantly (p < 0.05) less well represented compared to radiology (M = 3.62, SD = 0.77), pathology (M = 4.42, SD = 0.49) and patient history (M = 3.91, SD = 0.48).

MDT evaluation via direct observation in a meeting is feasible and reliable. We found consistent levels of quality of information coverage and contribution within the team, but certain aspects could be improved. Contribution to patient review resides predominantly with surgeons, while presented patient information is largely of biomedical nature. These findings can be fed to cancer MDTs to identify potential interventions for improvement.

In current cancer care, multidisciplinary team meetings (MDTMs) aim at uniting care professionals from different disciplines to decide upon the best possible treatment plan for the patients based on the available scientific evidence. In Belgium, the multidisciplinary approach is mandatory and formally regulated since 2003. Current research indicates that MDTMs are not always truly multidisciplinary, ie, with a mix of medical as well as paramedical disciplines, and that the medical profession (physicians and medical specialists) tends to dominate the interaction in MDTMs. To ensure that MDTMs can benefit from their diverse membership to achieve their full potential, significant attention should be devoted to the multidisciplinary character of these meetings. The aim of this study is to explore and describe the multidisciplinary character in MDTMs and how it is actually shaped in practice in different Flemish medical oncology departments.

For this study, we carried out an observational comparative case study. We studied 59 multidisciplinary team meetings at inpatient medical oncology departments in five different Belgian hospitals (academic as well as general) and explored multidisciplinarity and how it is actually shaped in practice.

The study is unique in identifying and analyzing three distinct types of MDTMs. The analysis of the three types revealed an inconsistent and, at times, contradictory picture of multidisciplinary team meetings. The findings also align with previous studies arguing that MDTMs in oncology are typically driven by doctors, with limited input of nurses and other nonmedical staff in which decisions are argued on biomedical information and far less consideration of psychosocial aspects.

The concept of a MDTM should not merely be a group of care professionals who work essentially independently and occasionally liaise with one another. Yet, this study has shown a worryingly low awareness of the true character of multidisciplinarity, particularly among medical disciplines.

• health services research
• interprofessional care
• medical oncology
• multidisciplinary teams
• qualitative research

• Decision Making
• Feasibility Studies
• Humans
• Interdisciplinary Communication
• Neoplasms/therapy
• Patient Care Team/organization & administration
• Quality of Health Care

• Aged
• Carcinoma, Pancreatic Ductal/diagnosis
• Carcinoma, Pancreatic Ductal/surgery
• Consensus Development Conferences as Topic
• Female
• Humans
• Male
• Middle Aged
• Outcome Assessment, Health Care/methods
• Outcome Assessment, Health Care/statistics & numerical data
• Pancreatectomy/methods
• Pancreatectomy/statistics & numerical data
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/surgery
• Prognosis
• Prospective Studies

• Adherence
• Deviance
• Head and neck
• Multidisciplinary meeting
• Neurooncology
• Sarcoma and musculoskeletal tumor
• Tumor board

• Breast cancer
• Conservative treatment
• Neoadjuvant therapy
• Sentinel lymph node
• Surgery

• health services
• healthcare quality
• neoplasms
• oncology service
• quality improvement
• quality of health care