Blasi Livio, Bordonaro Roberto, Serretta Vincenzo, Piazza Dario, Firenze Alberto, Gebbia Vittorio
Azienda di Rilievo Nazionale ad Alta Specializzazione Civico, Palermo, Italy.
Azienda di Rilievo Nazionale ad Alta Specializzazione Garibaldi, Catania, Italy.
JMIR Res Protoc. 2021 Sep 10;10(9):e26220. doi: 10.2196/26220.
Multidisciplinary tumor boards play a pivotal role in the patient-centered clinical management and in the decision-making process to provide best evidence-based, diagnostic, and therapeutic care to patients with cancer. Among the barriers to achieve an efficient multidisciplinary tumor board, lack of time and geographical distance play a major role. Therefore, the elaboration of an efficient virtual multidisciplinary tumor board (VMTB) is a key point to successfully obtain an oncology team and implement a network among health professionals and institutions. This need is stronger than ever during the COVID-19 pandemic.
This paper presents a research protocol for an observational study focused on exploring the structuring process and the implementation of a multi-institutional VMTB in Sicily, Italy. Other endpoints include analysis of cooperation between participants, adherence to guidelines, patients' outcomes, and patient satisfaction.
This protocol encompasses a pragmatic, observational, multicenter, noninterventional, prospective trial. The study's programmed duration is 5 years, with a half-yearly analysis of the primary and secondary objectives' measurements. Oncology care health professionals from various oncology subspecialties at oncology departments in multiple hospitals (academic and general hospitals as well as tertiary centers and community hospitals) are involved in a nonhierarchic manner. VMTB employs an innovative, virtual, cloud-based platform to share anonymized medical data that are discussed via a videoconferencing system both satisfying security criteria and compliance with the Health Insurance Portability and Accountability Act.
The protocol is part of a larger research project on communication and multidisciplinary collaboration in oncology units and departments spread in the Sicily region. The results of this study will particularly focus on the organization of VMTBs, involving oncology units present in different hospitals spread in the area, and creating a network to allow best patient care pathways and a hub-and-spoke relationship. The present results will also include data concerning organization skills and pitfalls, barriers, efficiency, number, and types with respect to clinical cases and customer satisfaction.
VMTB represents a unique opportunity to optimize patient management through a patient-centered approach. An efficient virtualization and data-banking system is potentially time-saving, a source for outcome data, and a detector of possible holes in the hull of clinical pathways. The observations and results from this VMTB study may hopefully be useful to design nonclinical and organizational interventions that enhance multidisciplinary decision-making in oncology.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/26220.
多学科肿瘤委员会在以患者为中心的临床管理以及为癌症患者提供基于最佳证据的诊断和治疗护理的决策过程中发挥着关键作用。在实现高效多学科肿瘤委员会的障碍中，时间不足和地理距离起着主要作用。因此，精心打造一个高效的虚拟多学科肿瘤委员会（VMTB）是成功组建肿瘤学团队并在卫生专业人员和机构之间建立网络的关键。在新冠疫情期间，这种需求比以往任何时候都更为迫切。
本文介绍了一项观察性研究的研究方案，该研究聚焦于探索意大利西西里岛一个多机构VMTB的构建过程及实施情况。其他终点包括分析参与者之间的合作、对指南的遵循情况、患者的治疗结果以及患者满意度。
该方案涵盖一项务实、观察性、多中心、非干预性的前瞻性试验。研究计划为期5年，每半年对主要和次要目标指标进行分析。多家医院（学术医院、综合医院以及三级医疗中心和社区医院）肿瘤科室的各肿瘤亚专业护理人员以非等级制方式参与其中。VMTB采用创新的虚拟云平台来共享匿名医疗数据，这些数据通过视频会议系统进行讨论，既满足安全标准，又符合《健康保险流通与责任法案》。
该方案是西西里岛地区肿瘤科室和部门关于沟通与多学科协作的一个更大研究项目的一部分。本研究结果将特别关注VMTB的组织情况，涉及该地区不同医院的肿瘤科室，并创建一个网络以实现最佳的患者护理路径和中心辐射型关系。目前的结果还将包括有关组织技能、陷阱、障碍、效率、临床病例数量和类型以及客户满意度的数据。
VMTB代表了一个通过以患者为中心的方法优化患者管理的独特机会。一个高效的虚拟化和数据库系统可能节省时间，是结果数据的来源，也是临床路径中可能存在漏洞的探测器。这项VMTB研究的观察结果和结果有望为设计增强肿瘤学多学科决策的非临床和组织干预措施提供帮助。
国际注册报告识别码（IRRID）：DERR1-10.2196/26220
