Kunkler I H, Prescott R J, Lee R J, Brebner J A, Cairns J A, Fielding R G, Bowman A, Neades G, Walls A D F, Chetty U, Dixon J M, Smith M E, Gardner T W, Macnab M, Swann S, Maclean J R
Department of Clinical Oncology, Western General Hospital, Edinburgh EH4 2XU, United Kingdom.
Eur J Cancer. 2007 Nov;43(17):2506-14. doi: 10.1016/j.ejca.2007.08.026. Epub 2007 Oct 24.
The TELEMAM trial aimed to assess the clinical effectiveness and costs of telemedicine in conducting breast cancer multi-disciplinary meetings (MDTs).
Over 12 months 473 MDT patient discussions in two district general hospitals (DGHs) were cluster randomised (2:1) to the intervention of telemedicine linkage to breast specialists in a cancer centre or to the control group of 'in-person' meetings. Primary endpoints were clinical effectiveness and costs. Economic analysis was based on a cost-minimisation approach.
Levels of agreement of MDT members on a scale from 1 to 5 were high and similar in both the telemedicine and standard meetings for decision sharing (4.04 versus 4.17), consensus (4.06 versus 4.20) and confidence in the decision (4.16 versus 4.07). The threshold at which the telemedicine meetings became cheaper than standard MDTs was approximately 40 meetings per year.
Telemedicine delivered breast cancer multi-disciplinary meetings have similar clinical effectiveness to standard 'in-person' meetings.
TELEMAM试验旨在评估远程医疗在开展乳腺癌多学科会诊（MDT）中的临床效果和成本。
在12个月的时间里，两家地区综合医院（DGH）的473次MDT患者讨论被整群随机分组（2:1），分别接受与癌症中心乳腺专科医生进行远程医疗联系的干预措施，或接受“面对面”会诊的对照组措施。主要终点是临床效果和成本。经济分析基于成本最小化方法。
MDT成员在1至5分的量表上的一致性水平很高，在远程医疗会诊和标准会诊中，决策共享（4.04对4.17）、达成共识（4.06对4.20）以及对决策的信心（4.16对4.07）方面相似。远程医疗会诊比标准MDT会诊更便宜的阈值约为每年40次会诊。
通过远程医疗进行的乳腺癌多学科会诊与标准的“面对面”会诊具有相似的临床效果。
Zotero 插件