Research Unit for Safety in Health, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Comprehensive Cancer Center Graz, Medical University of Graz and University Hospital Graz, Graz, Austria.
PLoS One. 2019 Feb 15;14(2):e0212556. doi: 10.1371/journal.pone.0212556. eCollection 2019.
Tumor boards (TB) play an important role to formulate a management plan for the treatment of patients with a malignancy. Recent evidence suggests that optimally functioning teams (teamwork, communication and decision making) are major prerequisites to conduct efficient TB meetings. The aims of this study were i) to use a readily published tool as a template for the development of a teamwork perspective extended assessment tool and ii) to evaluate the tool in a feasibility study by clinical and non-clinical observers.
A systematic literature search in four databases revealed the "Metric for the Observation of Decision-making (MODe)" to be consistently used. MODe served as a template for the clinical evaluation, additional, notably teamwork items were integrated, and the resulting tool was tested in a feasibility study in TBs by clinical and non-clinical observers. The percentage of agreement between observers was assessed in a two-step approach: first, agreement of raters on discussion of items by TB members, and second, agreement of raters based on ordinal scale.
In total, 244 patients were discussed in 27 TB sessions, thereof 136 (56%) fast track cases and 108 (44%) complex cases. In 228 (93%) of all cases an agreement for recommendation of a treatment plan was reached. Observers showed in general high agreement on discussion of the items. For the majority of items, the percentage of agreement between the different pairs of rater was similar and mostly high.
A newly developed TB team performance tool using MODe as a template was piloted in a German-speaking country and enabled the assessment of specialized multidisciplinary teams with a special focus on teamwork patterns. The developed assessment tool requires evaluation in a larger collective for validation, and additional assessment whether it can be applied equally by non-clinicians and clinicians.
肿瘤委员会（TB）在制定恶性肿瘤患者治疗管理计划方面发挥着重要作用。最近的证据表明，高效运作的团队（团队合作、沟通和决策制定）是进行高效 TB 会议的主要前提。本研究的目的是 i）使用已发表的工具作为模板来开发扩展的团队合作视角评估工具，以及 ii）通过临床和非临床观察员的可行性研究来评估该工具。
在四个数据库中进行系统文献检索，发现“决策观察量表（MODe）”被一致使用。MODe 作为临床评估的模板，纳入了其他重要的团队合作项目，所得工具在 TB 中由临床和非临床观察员进行了可行性研究测试。观察者之间的一致性百分比通过两步评估方法进行评估：首先，观察者对 TB 成员讨论项目的一致性；其次，观察者基于有序量表的一致性。
共 27 个 TB 会议讨论了 244 例患者，其中 136 例（56%）为快速通道病例，108 例（44%）为复杂病例。在所有病例中，228 例（93%）达成了治疗计划推荐的共识。观察者在讨论项目方面总体上表现出高度一致。对于大多数项目，不同配对观察者之间的一致性百分比相似且通常较高。
一种新开发的使用 MODe 作为模板的 TB 团队绩效工具已在德语国家进行了试点，并使评估专业化的多学科团队成为可能，重点关注团队合作模式。所开发的评估工具需要在更大的团队中进行验证评估，以及评估其是否可以由非临床医生和临床医生平等应用。
