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多学科癌症会议:系统评价与实践标准制定

Multidisciplinary cancer conferences: a systematic review and development of practice standards.

作者信息

Wright F C, De Vito C, Langer B, Hunter A

机构信息

Division of General Surgery, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ont., Canada M4N 3M5. Frances.

出版信息

Eur J Cancer. 2007 Apr;43(6):1002-10. doi: 10.1016/j.ejca.2007.01.025. Epub 2007 Feb 27.

Abstract

BACKGROUND

Multidisciplinary cancer conferences (MCCs) are a forum for health care providers to discuss diagnostic and treatment aspects of a cancer patient's care. In Ontario, we have found that very few hospitals have developed cancer conferences or forums for the prospective discussion of patient cancer care. In this paper, we describe the process of creating a province-wide standards document for MCCs.

METHODS

A systematic review and environmental scan were conducted to evaluate the literature regarding the impact of MCCs on physician practice patterns and patient outcomes, using the methodology of the Practice Guidelines Development Cycle. An Expert Panel was created to develop draft MCC standards. Ontario administrators and practitioners were surveyed to elicit feedback regarding the standards document. The findings were collated, and practice standards were developed.

RESULTS

Multidisciplinary care, predominantly in the form of multidisciplinary clinics, has been shown to improve patient outcomes. While only limited evidence suggested a benefit for MCCs, they have been documented as influential in changing patient management plans. MCCs were also found to be part of standard cancer care on an international level. Ontario practitioners surveyed generally supported MCC implementation.

DISCUSSION

We have described the process of creating an Ontario MCC standards document, including a literature review and an examination of the attitudes of Ontario practitioners and hospital administrators regarding the development and implementation of a MCC Standards document.

摘要

背景

多学科癌症会议(MCCs)是医疗保健提供者讨论癌症患者护理的诊断和治疗方面的一个论坛。在安大略省,我们发现很少有医院举办癌症会议或论坛来前瞻性地讨论患者的癌症护理。在本文中,我们描述了为多学科癌症会议创建一份全省标准文件的过程。

方法

采用实践指南制定周期的方法,进行了系统综述和环境扫描,以评估关于多学科癌症会议对医生实践模式和患者结局影响的文献。成立了一个专家小组来制定多学科癌症会议标准草案。对安大略省的管理人员和从业者进行了调查,以征求他们对标准文件的反馈意见。对调查结果进行了整理,并制定了实践标准。

结果

多学科护理,主要是以多学科诊所的形式,已被证明可改善患者结局。虽然仅有有限的证据表明多学科癌症会议有好处,但它们已被记录在案,对改变患者管理计划有影响。多学科癌症会议在国际层面上也被视为标准癌症护理的一部分。接受调查的安大略省从业者普遍支持多学科癌症会议的实施。

讨论

我们描述了创建安大略省多学科癌症会议标准文件的过程,包括文献综述以及对安大略省从业者和医院管理人员对多学科癌症会议标准文件的制定和实施态度的考察。

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