• API
• Fast Healthcare Interoperability Resources
• HIS
• ICT
• MDT
• application programming interface
• cancer
• clinic
• data integration
• decision support
• digital tools
• digitize
• eHealth
• health care
• health care professionals
• hospital
• hospital information system
• information and communication technology
• information system
• lung
• lung cancer
• medical data
• multidisciplinary cancer care
• multidisciplinary team
• multidisciplinary team meetings
• patient care
• platform
• process re-engineering
• treatment
• tumor board

• Humans
• Lung Neoplasms/therapy
• Health Information Interoperability
• Patient Care Team/organization & administration
• Workflow
• Taiwan

• collaborative management
• hemophagocytic lymphohistiocytosis
• immune dysregulation
• institutional implementation
• multidisciplinary teams
• quality improvement research

• Humans
• Patient Care Team/organization & administration
• Immune System Diseases/therapy
• Immune System Diseases/diagnosis
• Disease Management

• Clinical practice guideline
• Comité multidisciplinar de tumores
• Decision making
• Encuestas y cuestionarios
• Equipo de atención al paciente
• Guía de práctica clínica
• Indicadores de calidad
• Information technology
• Neoplasias
• Neoplasms
• Patient care team
• Quality indicators
• Radiology
• Radiology information system
• Radiología
• Sistema de información radiológica
• Surveys and questionnaires
• Tecnología de la información
• Toma de decisiones
• Tumour board

• Spain
• Radiologists/statistics & numerical data
• Humans
• Needs Assessment
• Specialty Boards
• Radiology/education
• Surveys and Questionnaires
• Female
• Male

• low middle-income countries
• medical education
• multidisciplinary team
• multidisciplinary team meetings
• musculoskeletal tumours

• health economic evaluation
• health-related quality of life
• infectiology
• limb function
• open fracture
• open soft tissue damage
• plastic surgery
• telemedicine
• work engagement
• workload

• Humans
• Fractures, Open/surgery
• Germany
• Lower Extremity/surgery
• Lower Extremity/injuries
• Surgical Wound Infection/economics
• Surgical Wound Infection/therapy
• Surgical Wound Infection/prevention & control
• Patient Care Team
• Postoperative Complications/epidemiology
• Female
• Male

• hospital
• interdisciplinary communication
• leadership
• multidisciplinary teams
• oncology service
• teamwork

• Humans
• Qualitative Research
• Patient Care Team/organization & administration
• Attitude of Health Personnel
• Medical Oncology/methods
• New South Wales
• Neoplasms/therapy
• Neoplasms/psychology
• Female

• APP1135048 National Health and Medical Research Council

• Cross-sectional studies
• Immunotherapy
• Pancreatic neoplasms
• Surveys and Questionnaires

• computer algorithm
• hepatocellular carcinoma
• machine learning
• multidisciplinary decision-making
• tumor board

• breast cancer care
• breast cancer multidisciplinary team
• patient perspectives
• patient-centered care
• psychosocial information
• shared decision-making

• Canon Medical Systems Corporation

• Adult oncology
• CHEMOTHERAPY
• ONCOLOGY
• RADIOTHERAPY
• Systematic Review

• Humans
• Databases, Factual
• Health Facilities
• Health Personnel
• Interdisciplinary Studies
• Patient Care Team
• Research Design
• Scoping Reviews As Topic

• breast cancer healthcare pathway improvement
• clinical decision support systems
• electronic medical records
• stakeholder involvement
• workflow efficiency improvement

• COVID-19 pandemic
• Multidisciplinary team meeting
• virtual conferencing oncology

• Humans
• Pandemics
• Patient Care Team
• COVID-19/epidemiology
• Neoplasms/epidemiology
• Neoplasms/therapy
• Disease Outbreaks

• interdisciplinary
• interprofessional team meeting
• lifestyle medicine
• musculoskeletal care
• orthopedics

• Jacqueline N. Baker Washington University Living Well Center Baker Trust
• Doris Duke Charitable Foundation-Fund to Retain Clinical Scientists
• National Institute of Arthritis and Musculoskeletal and Skin Diseases

• Patient care team
• multidisciplinary team meeting
• nasopharyngeal carcinoma
• oncology service

• Dr Sardjito Research Grant Funding Program 2019

• 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

• Child
• Humans
• Female
• Adult
• Cross-Sectional Studies
• Medical Oncology
• Parents
• Physicians
• Radiology

• lung cancer
• oncogenomics
• personalized medicine
• semiconductors
• smart sensors

• breast cancer
• multidisciplinary team
• survival rate
• systematic review

• Humans
• Carcinoma, Hepatocellular
• Liver Neoplasms

• R01 CA256977 NCI NIH HHS
• R01 MD012565 NIMHD NIH HHS
• U01 CA271888 NCI NIH HHS

• Clinical trials
• European regulation
• access to innovation
• authorisation
• indicators
• regulatory science

• Humans
• Europe
• Clinical Trials as Topic/legislation & jurisprudence
• Government Regulation

• IT platform
• digital health
• impact analysis
• implementation
• multidisciplinary tumor boards
• rectal cancer

• Humans
• Pandemics
• COVID-19/epidemiology
• Rectal Neoplasms/therapy
• Health Personnel
• Italy/epidemiology

Malignant splenic tumors are rare but fatal, presenting a challenge in diagnosis and management involving hematology, oncology, and general surgery. By contrast, diagnosing and treating other common malignant tumors (such as lung and gastrointestinal cancer) offers multiple strategies for chemotherapy, radiotherapy, targeted therapy, and immunotherapy with the prospect of a cure. With various specialists involved in clinical multiple disciplinary team (MDT) discussion, personal bias can be minimized. It can also ignite important discussion which can benefit not only one patient but many patients.

Here, we report on the MDT diagnosis and management of the malignant splenic tumors littoral cell angiosarcoma and histiocytic sarcoma. Although only two cases of rare primary splenic malignancy are presented, MDT is a novel means of rare disease treatment.

To benefit patients, imaging analysis, safe operation, precise pathology examination, and individualized therapeutic treatment strategies are required. The involvement of various specialists in a clinical MDT discussion minimizes personal bias and can create important ideas to benefit all patients.

• Multiple disciplinary team
• Splenic malignancy
• Littoral cell angiosarcoma
• Histiocytic sarcoma
• Case report

• Complications
• Laparoscopic pancreaticoduodenectomy
• Laparoscopic radical antegrade modular pancreatosplenectomy
• Neoadjuvant chemotherapy
• Pancreatic ductal adenocarcinoma

Lung cancer continues to be the largest cause of cancer-related mortality among men and women globally, accounting for around 27% of all cancer-related deaths. Recent advances in lung cancer medicines, particularly for non-small-cell lung cancer (NSCLC), have increased the need for multidisciplinary disease care, thereby enhancing patient outcomes and quality of life. Different studies in the European community have evaluated the impact of multidisciplinary care on outcomes for lung cancer patients, including its impact on survival, adherence to guideline treatment, utilization of all treatment modalities, timeliness of treatment, patient satisfaction, quality of life, and referral to palliative care. This publication will examine the roles and duties of all multidisciplinary members and the influence of multidisciplinary care on lung cancer outcomes in Europe. Multidisciplinary treatment is the foundation of lung cancer treatment. The optimal setting for interdisciplinary collaboration between specialists with complementary functions is multidisciplinary meetings. Multidisciplinary care in lung cancer facilitates the delivery of a high-quality service, which may improve lung cancer patients’ survival, utilization of all treatment modalities, adherence to guideline management, and quality of life, despite the fact that only limited observational data have demonstrated these results. To confirm the relationship between multidisciplinary treatment and improved lung cancer patient outcomes, however, further research is required.

• lung cancer
• multidisciplinary management
• tailored therapy

Background: Cancer patients’ experiences of the healthcare system, care, and treatment are increasingly viewed as important in order to inform and improve quality of care, patient safety, and treatment efficacy. Understanding patient experience is a key step in moving toward patient-centred care. The aims of this study were to determine the experience of cancer patients in Central and Eastern European countries and to identify the needs and perspectives of oncological patients during the cancer treatment. In this paper, results from Croatia are presented. Methods: A sixty-nine item online survey was translated by native-language participating countries. Only registered members (subjects with confirmed cancer diagnosis) of the national patient oncology associations in each participating country were allowed to access and complete the online questionnaire (n = 16,458). Data were collected between October 2018 to February 2019. The Croatian Coalition of Health Associations enabled the authors of this paper to use the collected data from a sample of the Croatian participants (n = 2460) for the purposes of publication. Results: Two-thirds (67.3%) of the respondents reported satisfaction with the length of time needed for getting tests done. Bad news was delivered sensitively to 52.97% of the participants, and 52.76% received a cancer treatment plan. During the hospitalisation, 45.93% responded that they did not find someone from the hospital staff whom they could talk to about their worries and fears, and 57.48% were not given any contact information in case of concerns about their condition or treatment following the discharge. Regarding the patients’ preferences, needs, and values, 60.81% of the respondents felt that the greatest improvement would be to perform all services in one place, and 55.28% felt that improvement would be achieved through a multidisciplinary team coordinated by one person. Conclusions: The study reveals domains that need to be addressed in the overall Croatian healthcare system for oncology patients. Based on the obtained data, we can conclude that there is a large need for improvement in patient experience on the oncology pathway.

• Croatia
• Humans
• Language
• Neoplasms/therapy
• Patient Outcome Assessment
• Patient Satisfaction
• Surveys and Questionnaires

• breast unit
• chemotherapy - oncology
• clinical decision
• early breast cancer (EBS)
• elderly patients
• endocrine therapy
• multidisciplinary team (MDT)

Background

Virtual tumor board (VTB) platforms are an important aspect of cancer management. They enable easier access to a multidisciplinary team of experts. To deliver high-quality cancer care, it is necessary to coordinate numerous therapies and providers, share technical knowledge, and maintain open lines of communication among all professionals involved. The VTB is an essential tool in the diagnosis and treatment of brain cancer. For patients with glioma and brain metastases, multidisciplinary tumor board guidelines should guide diagnosis and therapy throughout the course of the illness. VTBs are an emerging resource across various cancer care networks in the United States.

Methodology

We performed a systematic search of all VTBs incorporating a platform designed for this specific role. We reviewed the records of the Genomet VTB, the Medical University of South Carolina (MUSC) VTB, and Xcures VTB. Summary data examined included the year of launch, demographics, characteristics of cases, average response time, advantages, and how they handle protected health information.

Results

Overall, 30% of VTBs examined were launched in 2017. All had a Health Insurance Portability and Accountability Act-compliant online environment. On a review of Xcures records, the median age of the female patients was 57 years and the median age of the male patients was 55 years. The data showed that 44% (4.4 out of every 10 patients) with a confirmed treatment chose the VTB integrated option. Overall, 76% of patients in the Xcures registry had primary central nervous system tumors, with at least 556 patients in the tumor registry which included 46% glioblastoma cases (96% primary, 4% secondary). In the MUSC VTB project, 112 thoracic tumor cases and nine neuro-oncology cases were reviewed. The tumor board met weekly, and the average response time was within 24 hours of case review and presentation. The Genomet VTB de-identifies all patient information; this is a virtual platform primarily focused on neuro-oncology cases. Cases involved a median of five specialists most commonly neuro-oncologists, neurosurgeons, radiation oncologists, molecular pathologists, and neuroradiologists. The case review revealed an age range of six months to 84 years (mean age = 44.5 years), with 69.6% males and 30.4% females, 43.5% glioblastomas, 8.7% adenocarcinomas, and 8.7% infratentorial tumors. The average response time observed in all cases was ≤24 hours.

Conclusions

VTBs allow for quicker expert analysis of cases. This has resulted in an accelerated number of cases reviewed with a shortened communication time. More studies are needed to gain additional insights into user engagement metrics.

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

Multidisciplinary team meetings formulate guideline-based individual treatment plans based on patient and disease characteristics and motivate reasons for deviation. Clinical decision trees could support multidisciplinary teams to adhere more accurately to guidelines. Every clinical decision tree is tailored to a specific decision moment in a care pathway and is composed of patient and disease characteristics leading to a guideline recommendation.

This study investigated (1) the concordance between multidisciplinary team and clinical decision tree recommendations and (2) the completeness of patient and disease characteristics available during multidisciplinary team meetings to apply clinical decision trees such that it results in a guideline recommendation.

This prospective, multicenter, observational concordance study evaluated 17 selected clinical decision trees, based on the prevailing Dutch guidelines for breast, colorectal and prostate cancers. In cases with sufficient data, concordance between multidisciplinary team and clinical decision tree recommendations was classified as concordant, conditional concordant (multidisciplinary team specified a prerequisite for the recommendation) and non-concordant.

Fifty-nine multidisciplinary team meetings were attended in 8 different hospitals, and 355 cases were included. For 296 cases (83.4%), all patient data were available for providing an unconditional clinical decision tree recommendation. In 59 cases (16.6%), insufficient data were available resulting in provisional clinical decision tree recommendations. From the 296 successfully generated clinical decision tree recommendations, the multidisciplinary team recommendations were concordant in 249 (84.1%) cases, conditional concordant in 24 (8.1%) cases and non-concordant in 23 (7.8%) cases of which in 7 (2.4%) cases the reason for deviation from the clinical decision tree generated guideline recommendation was not motivated.

The observed concordance of recommendations between multidisciplinary teams and clinical decision trees and data completeness during multidisciplinary team meetings in this study indicate a potential role for implementation of clinical decision trees to support multidisciplinary team decision-making.

• Clinical decision trees
• algorithms
• clinical decision support system
• clinical practice guidelines
• multidisciplinary team meeting
• oncology

• Decision Support Systems, Clinical
• Humans
• Male
• Medical Oncology/methods
• Patient Care Planning
• Patient Care Team
• Prospective Studies

• COVID-19
• adult oncology
• oncology
• paediatric oncology
• palliative care

• Humans
• Medical Oncology
• Overtreatment
• Patient Care Team
• Videoconferencing

Multidisciplinary care is needed to decide the best therapeutic approach and to provide optimal care to patients with lung cancer (LC). Multidisciplinary teams (MDTs) are optimal strategies for the management of patients with LC and have been associated with better outcomes, such as an increase in quality of life and survival. The Spanish Lung Cancer Group has promoted this review about the current situation of the existing national LC-MDTs, which also offers a set of excellence requirements and quality indicators to achieve the best care in any patient with LC. Time and sufficient resources; leadership; administrative and institutional support; and recording of activity are key factors for the success of LC-MDTs. A set of excellence requirements in terms of staff, resources and organization of the LC-MDT have been proposed. At last, a list of quality indicators has been agreed to achieve and measure the performance of current LC-MDTs.

• Lung neoplasms (MeSH)
• Multidisciplinary team
• Quality indicators (MeSH)
• Quality of health care (MeSH)
• Tumor board

• clinical decisions
• communication
• education and training
• end of life care
• hospital care

• MCCC-FCO-11-U Marie Curie

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

Multidisciplinary tumor boards (TBs) are the gold standard for decision-making in cancer care. Variability in preparation, conduction, and impact is widely reported. The benefit of digital technologies to support TBs is unknown. This study evaluated the impact of the NAVIFY Tumor Board solution (NTB) on TB preparation time across multiple user groups in 4 cancer categories: breast, GI, head and neck (ie, ear, nose, and throat, or ENT), and hematopathology.

This prospective study evaluated TB preparation time in multiple phases pre- and post-NTB implementation at an academic health care center. TB preparation times were recorded for multiple weeks using a digital time tracker.

Preparation times for 59 breast, 61 GI, 36 ENT, and 71 hematopathology cancer TBs comparing a pre-NTB phase to 3 phases of NTB implementation were evaluated between February 2018 and July 2019. NTB resulted in significant reductions in overall preparation time (30%) across 3 TBs pre-NTB compared with the final post-NTB implementation phase. In the breast TB, NTB reduced overall preparation time by 28%, with a 76% decrease in standard deviation (SD). In the GI TB, a 23% reduction in average preparation time was observed for all users, with a 48% decrease in SD. In the ENT TB, a 33% reduction in average preparation time was observed for all users, with a 73% decrease in SD. The hematopathology TB, which was the cocreation partner and initial adopter of the solution, showed variable results.

This study showed a significant impact of a digital solution on time preparation for TBs across multiple users and different TBs, reflecting the generalizability of the NTB. Adoption of such a solution could improve the efficiency of TBs and have a direct economic impact on hospitals.

• Collaborative care
• Nursing
• Palliative care
• Sarcoma
• Specialist nurses

Healthcare providers decide on recommendations for further treatment of patients with cancer in multidisciplinary tumor boards (MTBs). As such, communicative processes during MTBs are assumed to influence decision-making and, thereby, treatment planning. The aim of this exploratory study is to gain insights into decision-making during MTBs.

Case discussions from MTBs in breast cancer centers in North Rhine-Westphalia, Germany, were observed and audiotaped. The transcripts of the audio recordings were analyzed by procedures of conversation analysis.

Based on 38 case discussions from 15 MTBs in four breast cancer centers, an action scheme for decision-making in MTBs in breast cancer care was developed. In addition, the conversational practices used by the participants during interactions were analyzed.

Analysis indicated that conventions in MTBs were observed during individual phases of decision-making but not for the entire process. Although exchanging multidisciplinary knowledge is an essential aspect of MTBs, this exchange does not always seem to occur in practice. The extent to which recommendations are derived from consensus during MTBs remains unclear. Thus, the study suggests developing standards for communication during MTBs to optimize decision-making and, thus, the quality of recommendation.

• breast cancer
• communication
• multidisciplinary treatment team
• multidisciplinary tumor conferences
• oncology