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Feasibility of a multdisciplinary lung cancer videoconference between a peripheral hospital and a comprehensive cancer centre.基层医院与综合性癌症中心之间开展肺癌多学科远程视频会议的可行性。
Oncology. 2013;84(3):186-90. doi: 10.1159/000345314. Epub 2013 Jan 15.
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Multidisciplinary cancer conferences: identifying opportunities to promote implementation.多学科癌症会议:寻找促进实施的机会。
Ann Surg Oncol. 2009 Oct;16(10):2731-7. doi: 10.1245/s10434-009-0639-6. Epub 2009 Aug 7.
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Challenges in multidisciplinary cancer care among general surgeons in Canada.加拿大普通外科医生在多学科癌症护理方面面临的挑战。
BMC Med Inform Decis Mak. 2008 Dec 22;8:59. doi: 10.1186/1472-6947-8-59.
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TELEMAM: a cluster randomised trial to assess the use of telemedicine in multi-disciplinary breast cancer decision making.TELEMAM:一项评估远程医疗在多学科乳腺癌决策中应用的整群随机试验。
Eur J Cancer. 2007 Nov;43(17):2506-14. doi: 10.1016/j.ejca.2007.08.026. Epub 2007 Oct 24.
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Determinants of implementation effectiveness: adapting a framework for complex innovations.实施效果的决定因素:适配复杂创新的框架
Med Care Res Rev. 2007 Jun;64(3):279-303. doi: 10.1177/1077558707299887.
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Place of multidisciplinary consulting meetings and clinical trials in the management of colorectal cancer in France in 2000.2000年法国结直肠癌管理中多学科咨询会议及临床试验的开展地点。
Gastroenterol Clin Biol. 2007 Mar;31(3):286-91. doi: 10.1016/s0399-8320(07)89375-4.
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Multidisciplinary cancer conferences: a systematic review and development of practice standards.多学科癌症会议:系统评价与实践标准制定
Eur J Cancer. 2007 Apr;43(6):1002-10. doi: 10.1016/j.ejca.2007.01.025. Epub 2007 Feb 27.
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Multidisciplinary teams in cancer care: are they effective in the UK?癌症护理中的多学科团队:它们在英国有效吗?
Lancet Oncol. 2006 Nov;7(11):935-43. doi: 10.1016/S1470-2045(06)70940-8.
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The impact of the Calman-Hine report on the processes and outcomes of care for Yorkshire's colorectal cancer patients.卡尔曼-海因报告对约克郡结直肠癌患者护理流程及结果的影响。
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10
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区域虚拟肿瘤病例讨论会的实施:一项评估可行性和医疗服务提供者接受度的前瞻性研究

Implementation of a regional virtual tumor board: a prospective study evaluating feasibility and provider acceptance.

作者信息

Marshall Christy L, Petersen Nancy J, Naik Aanand D, Vander Velde Nancy, Artinyan Avo, Albo Daniel, Berger David H, Anaya Daniel A

机构信息

1 Michael E. DeBakey Department of Surgery, Baylor College of Medicine , Houston, Texas.

出版信息

Telemed J E Health. 2014 Aug;20(8):705-11. doi: 10.1089/tmj.2013.0320. Epub 2014 May 20.

DOI:10.1089/tmj.2013.0320
PMID:24845366
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4106373/
Abstract

BACKGROUND

Tumor board (TB) conferences facilitate multidisciplinary cancer care and are associated with overall improved outcomes. Because of shortages of the oncology workforce and limited access to TB conferences, multidisciplinary care is not available at every institution. This pilot study assessed the feasibility and acceptance of using telemedicine to implement a virtual TB (VTB) program within a regional healthcare network.

MATERIALS AND METHODS

The VTB program was implemented through videoconference technology and electronic medical records between the Houston (TX) Veterans Affairs Medical Center (VAMC) (referral center) and the New Orleans (LA) VAMC (referring center). Feasibility was assessed as the proportion of completed VTB encounters, rate of technological failures/mishaps, and presentation duration. Validated surveys for confidence and satisfaction were administered to 36 TB participants to assess acceptance (1-5 point Likert scale). Secondary outcomes included preliminary data on VTB utilization and its effectiveness in providing access to quality cancer care within the region.

RESULTS

Ninety TB case presentations occurred during the study period, of which 14 (15%) were VTB cases. Although one VTB encounter had a technical mishap during presentation, all scheduled encounters were completed (100% completion rate). Case presentations took longer for VTB than for regular TB cases (p=0.0004). However, VTB was highly accepted with mean scores for satisfaction and confidence of 4.6. Utilization rate of VTB was 75%, and its effectiveness was equivalent to that observed for non-VTB cases.

CONCLUSIONS

Implementation of VTB is feasible and highly accepted by its participants. Future studies should focus on widespread implementation and validating the effectiveness of this model.

摘要

背景

肿瘤病例讨论会(TB)有助于多学科癌症护理,并与整体预后改善相关。由于肿瘤学劳动力短缺以及参加TB会议的机会有限,并非每个机构都能提供多学科护理。这项试点研究评估了使用远程医疗在区域医疗网络内实施虚拟TB(VTB)计划的可行性和可接受性。

材料与方法

VTB计划通过视频会议技术和电子病历在休斯顿(德克萨斯州)退伍军人事务医疗中心(VAMC)(转诊中心)和新奥尔良(路易斯安那州)VAMC(转诊中心)之间实施。可行性评估指标包括完成的VTB会诊比例、技术故障/事故发生率和报告时长。对36名TB参与者进行了关于信心和满意度的有效调查,以评估接受程度(1 - 5点李克特量表)。次要结果包括关于VTB利用率及其在该地区提供优质癌症护理可及性方面有效性的初步数据。

结果

在研究期间共进行了90次TB病例报告,其中14次(15%)为VTB病例。尽管有一次VTB会诊在报告过程中出现技术问题,但所有预定的会诊都完成了(完成率100%)。VTB病例报告比常规TB病例花费的时间更长(p = 0.0004)。然而,VTB的接受度很高,满意度和信心的平均得分均为4.6。VTB的利用率为75%,其有效性与非VTB病例相当。

结论

VTB的实施是可行的,并且其参与者对其接受度很高。未来的研究应侧重于广泛实施并验证该模式的有效性。