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多学科团队会议对肿瘤学环境中患者评估、管理和结局的影响:文献系统评价。

The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature.

机构信息

Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia.

Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Australian Prostate Cancer Research, North Melbourne, Victoria, Australia.

出版信息

Cancer Treat Rev. 2016 Jan;42:56-72. doi: 10.1016/j.ctrv.2015.11.007. Epub 2015 Nov 24.

Abstract

BACKGROUND

Conducting regular multidisciplinary team (MDT) meetings requires significant investment of time and finances. It is thus important to assess the empirical benefits of such practice. A systematic review was conducted to evaluate the literature regarding the impact of MDT meetings on patient assessment, management and outcomes in oncology settings.

METHODS

Relevant studies were identified by searching OVID MEDLINE, PsycINFO, and EMBASE databases from 1995 to April 2015, using the keywords: multidisciplinary team meeting* OR multidisciplinary discussion* OR multidisciplinary conference* OR case review meeting* OR multidisciplinary care forum* OR multidisciplinary tumour board* OR case conference* OR case discussion* AND oncology OR cancer. Studies were included if they assessed measurable outcomes, and used a comparison group and/or a pre- and post-test design.

RESULTS

Twenty-seven articles met inclusion criteria. There was limited evidence for improved survival outcomes of patients discussed at MDT meetings. Between 4% and 45% of patients discussed at MDT meetings experienced changes in diagnostic reports following the meeting. Patients discussed at MDT meetings were more likely to receive more accurate and complete pre-operative staging, and neo-adjuvant/adjuvant treatment. Quality of studies was affected by selection bias and the use of historical cohorts impacted study quality.

CONCLUSIONS

MDT meetings impact upon patient assessment and management practices. However, there was little evidence indicating that MDT meetings resulted in improvements in clinical outcomes. Future research should assess the impact of MDT meetings on patient satisfaction and quality of life, as well as, rates of cross-referral between disciplines.

摘要

背景

定期进行多学科团队(MDT)会议需要大量的时间和财务投入。因此,评估这种实践的经验效益非常重要。本文对 MDT 会议对肿瘤学环境中患者评估、管理和结局的影响进行了系统评价,以评估相关文献。

方法

通过在 1995 年至 2015 年 4 月期间在 OVID MEDLINE、PsycINFO 和 EMBASE 数据库中搜索“multidisciplinary team meeting*”或“multidisciplinary discussion*”或“multidisciplinary conference*”或“case review meeting*”或“multidisciplinary care forum*”或“multidisciplinary tumour board*”或“case conference*”或“case discussion*”以及“oncology”或“cancer”等关键词,确定了相关研究。如果研究评估了可衡量的结果,并且使用了比较组和/或前后测试设计,则将其纳入研究。

结果

27 篇文章符合纳入标准。MDT 会议讨论的患者的生存结果改善证据有限。在 MDT 会议上讨论的患者中,有 4%至 45%的患者在会议后改变了诊断报告。在 MDT 会议上讨论的患者更有可能接受更准确和完整的术前分期和新辅助/辅助治疗。研究质量受到选择偏倚的影响,使用历史队列会影响研究质量。

结论

MDT 会议影响患者评估和管理实践。然而,几乎没有证据表明 MDT 会议改善了临床结局。未来的研究应该评估 MDT 会议对患者满意度和生活质量的影响,以及跨学科转诊的比例。

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