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

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

• behavioural science
• cancer management
• clinical guidelines
• clinical management
• lung cancer

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

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.

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

Tumor boards constitute the main consensus and clinical decision–making body of multidisciplinary teams (MDTs) in cancer care. With the increasing clinical complexity of treatment options (eg, targeted therapies, multimodal treatments) and the progressive incorporation of new areas of intervention (eg, survivorship care), tumor boards are now required to play a central role in all cancer processes. However, although frameworks are in place to evaluate MDT quality, only few web-based tools are available for this purpose; indeed, no web-based MDT evaluation tools have been developed for or adapted to the Spanish National Health System.

The first aim of this study was to develop a web-based self-assessment model (Autoevaluación de Equipos Multidisciplinares de Atención al Cáncer [AEMAC]) for evaluating multidisciplinary cancer teams in Spain and the second aim was to validate this tool by testing its metric properties, acceptability, and usability.

We designed and validated the AEMAC program in 3 stages. In the first stage (research), we reviewed the available scientific evidence and performed a qualitative case study of good practice in multidisciplinary care within the Spanish National Health System (n=4 centers and 28 health care professionals). The results were used to define the thematic areas and quality criteria for the self-evaluation model, which were then discussed and validated by a group of experts. The second stage (development) involved the technological development of a web app that would be accessible from any mobile device. In the third stage (piloting and validation), we conducted 4 pilot tests (n=15 tumor boards, 243 professionals) and used the results to analyze the acceptability and usefulness of the tool.

We designed a self-assessment model based on 5 thematic areas encompassing a total of 25 quality components, which users rated on a 3-option development scale. The evaluation process, which was managed entirely from the web app, consisted of individual self-assessment, group prioritization, and creation of an improvement plan. Cronbach alpha (.86), McDonald’s omega (0.88), and various fit indices (comparative fit index between 0.95 and 1 and goodness-of-fit index between 0.97 and 0.99 for all 5 aspects) confirmed internal consistency. The mean rating for overall satisfaction with the tool and for consistency between the content of the tool and the reality of tumor boards was 7.6 out of 10.

The results obtained during the period of research and piloting of the AEMAC program showed that it has an appropriate structure and metric properties and could therefore be implemented in a real context and generalized to other hospitals. As a virtual tool, it helps to measure the key aspects of MDT quality, such as effectiveness of collaboration and communication, leadership, and the organizational environment.

• cancer
• evaluation
• multidisciplinary care
• quality assurance
• web-based tool

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

The general practitioner (GP) is central to managing patients with cancer, whose numbers are increasing worldwide. The GP’s involvement requires better coordination between involved partners, in particular oncologists and GPs.

To conduct a feasibility study of remote participation of GPs in multi-disciplinary consultation meetings (MCMs). We analysed participation, participants’ satisfaction, and their impact on therapeutic decisions.

We conducted a feasibility study in the regional cancer centre of Toulouse, France. All patient cases discussed in the MCMs for myelodysplasia from 1 January to 31 March 2016 were included. Cases of patients aged over 18 years, with a diagnosis of myelodysplasia and registered with a GP were included if patients gave informed consent. One investigator collected the data provided by GPs during three telephone or video calls: before, during, and after the MCM, respectively.

Of 86 patient cases discussed during three months of MCMs, 44 were eligible for GP participation; 27 GPs participated in discussions of 27 patient cases. The GP’s participation in the MCM led to a change in management in five cases, with four times treatment intensifications and once de-intensification. Medical, social, family-related, and psychological domains were discussed with input from the GPs. Overall, all participants were satisfied with the MCMs.

Remote participation of GPs in MCMs is feasible and may result in adapting oncological and haematological management for patients. This patient-centred approach requires a specific organisation that, when implemented, satisfies the needs of all participants.

• Multi-disciplinary communication
• general practitioners
• medical oncology
• patient care team
• telemedicine

• cancer
• hospital care

• Cancer
• MDT
• Maturity model
• Multidisciplinary team
• Tumour board

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

• assessment
• complexity
• decision-making
• multidisciplinary teams
• observation
• optimisation
• quality improvement
• streamlining

• 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.

This study aimed to assess a multidisciplinary team (MDT) meeting approach for the management of patients with complex extremity defects, analyze treatment recommendations, and evaluate factors influencing non-implementation.

All patients introduced to an MDT meeting for complex extremity defects from 2015 to 2017 were included in a retrospective cohort study. Patients’ characteristics and defect causes were evaluated. Treatment recommendations (TR) of MDT meetings and subsequent implementation were reviewed (cohort with implementation of TR versus cohort with non-implementation of TR), and factors associated with non-adherence to recommendations were statistically analyzed using logistic regression.

Fifty-one patients (41 male) with a mean age of 54 years were presented in 27 MDT meetings. Most of the patients (70%) suffered from reconstructive challenging or combined bone- and soft tissue defects, primarily located at the lower extremity (88%). Large skeletal defects, chronic osteomyelitis, and multi-fragmented fractures were present in 65% of cases. Forty-five percent of the patients suffered from peripheral vascular disease, necessitating surgical optimization. Of the 51 MDT decisions, 40 were implemented (78%; (32/40) limb salvage versus 22%; (8/40) limb amputation). Limb salvage was successfully achieved in 91% (29/32) of the cases. Failed limb salvages were due to flap failure (33%; 1/3), recurring periprosthetic joint infections (66%; 2/3) and concomitant reconstructive failure. Patients who underwent limb amputation, as recommended, showed proper stump healing and regained mobility with a prosthesis. Overall the MDT treatment plan was effective in 92.5% (37/40) of the patients, who adhered to the MDT treatment recommendation. In eleven patients (22%; 11/51), the MDT treatment was not implemented. MDT decisions were less likely to be implemented, if amputation was recommended (p = 0.029).

MDT meetings represent a valid tool to formulate individualized treatment plans, avoiding limb amputation in most patients with severe extremity defects. Recommendation for limb amputation is less likely to be implemented than plans for limb salvage.

Trial registration: Retrospectively registered

• Bone reconstruction
• Complex extremity defects
• Free flap
• Multidisciplinary team meetings

• Biotherapy
• Biothérapies
• Hors-AMM.
• Innovating and expensive therapeutics
• Internal medicine
• Multidisciplinary team meetings
• Médecine interne
• Off-label
• Réunion de concertation pluridisciplinaire
• Thérapeutiques onéreuses

• diabetes care
• health disparities
• integrated care
• population health
• service redesign

• cancer
• cancer multidisciplinary team meetings
• decision making
• multidisciplinary teams

• Attitude of Health Personnel
• Clinical Decision-Making
• Cognition
• Cross-Sectional Studies
• England
• Female
• Group Processes
• Health Knowledge, Attitudes, Practice
• Humans
• Male
• Neoplasms/therapy
• Oncologists/psychology
• Patient Care Team
• Social Behavior
• Time Factors
• Workload

• COM-B behaviour change wheel
• Cancer
• Intervention design
• Knowledge translation
• Multidisciplinary cancer conference
• Multidisciplinary decision making
• Multidisciplinary tumor board
• Qualitative research
• Theoretical domains framework

• MDT
• Multidisciplinary team meeting
• Quality improvement
• Virtual worlds

• Diagnosis
• Disease management
• Interdisciplinary research
• Interdisciplinary studies
• Pancreas
• Pancreatitis

随着医疗水平的提高，疾病诊疗模式也发生了改变。肺癌是最常见的恶性肿瘤，也是诊疗极其复杂的疾病之一。多学科综合诊疗（multi-disciplinary treatment, MDT）协作组在肿瘤的诊疗中具有独特优势，但在国内并未得到广泛应用，故结合我院MDT团队诊疗和管理经验进行讨论及综述，阐述肺癌“一体化诊疗、全程管理”模式的发展现状及推广价值。

• Full-course management
• Lung neoplasms
• Multi-disciplinary treatment

• Exploratory factor analysis
• Multidisciplinary working
• Ovarian cancer

• Cross-Sectional Studies
• Decision Making
• Female
• Humans
• Interprofessional Relations
• Ovarian Neoplasms/therapy
• Patient Care Team/organization & administration
• Patient-Centered Care/methods
• Patient-Centered Care/organization & administration
• Practice Patterns, Physicians'/organization & administration
• Quality of Health Care

• 22647 Cancer Research UK

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

• comprehensive geriatric assessment
• high performing teams
• multidisciplinary teams
• non-technical skills
• older people
• patient safety

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.

• human factors
• multidisciplinary meeting
• pathology
• radiology
• surgery

• MDT
• incontinence
• multidisciplinary team
• pelvic floor dysfunction
• prolapse

• Multidisciplinary care
• oncology
• quality measurement
• tumor board

• Chemotherapy
• Head and neck cancer
• Multidisciplinary Team meeting
• Radiotherapy
• Surgery

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

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

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

• MDM
• cancer MDT
• cancer meeting
• patients with cancer

• Health Service Research
• Ibd
• Inflammatory Bowel Disease

• Guidelines
• Network
• Referral centre
• Sarcoma
• Treatment

• Cancer Care Facilities
• Delivery of Health Care/organization & administration
• Europe
• Humans
• Practice Guidelines as Topic
• Rare Diseases/diagnosis
• Rare Diseases/pathology
• Rare Diseases/therapy
• Referral and Consultation
• Registries
• Sarcoma/diagnosis
• Sarcoma/pathology
• Sarcoma/therapy

• Communication
• Cooperative Behavior
• Female
• Humans
• Middle Aged
• Ovarian Neoplasms/pathology
• Ovarian Neoplasms/therapy
• Patient Care Team/organization & administration
• Rectal Neoplasms/secondary
• Rectal Neoplasms/therapy

• Lean Six Sigma
• efficiency of care
• hospital care
• primary care
• quality improvement
• timely communication

• Cancer
• Paediatric oncology
• Survey
• Tumour boards

• HEALTH SERVICE RESEARCH
• IBD
• IBD CLINICAL
• IBD SURGERY

• Adult
• Attitude of Health Personnel
• Cooperative Behavior
• Female
• Focus Groups
• Germany
• Humans
• Inservice Training/methods
• Inservice Training/organization & administration
• Interdisciplinary Communication
• Interviews as Topic
• Male
• Middle Aged
• Patient Care Team/organization & administration
• Patient Care Team/standards
• Physical and Rehabilitation Medicine/education
• Physical and Rehabilitation Medicine/organization & administration
• Qualitative Research
• Workforce
• Young Adult