Oncology Haemtology, Kantonsspital St.Gallen, St.Gallen, Switzerland.
International Breast Cancer Study Group, Coordinating Center, Bern, Switzerland.
Cancer Rep (Hoboken). 2022 Aug;5(8):e1541. doi: 10.1002/cnr2.1541. Epub 2021 Sep 28.
Multidisciplinary care is pivotal in cancer centres and the interaction of all cancer disease specialists in decision making processes is state-of-the-art.
To describe differences of MDTMs by tumour type.
Twelve multidisciplinary team meetings (MDTMs) with participation of different cancer disease specialists at a tertiary hospital were assessed by an exploratory sequential mixed method approach with interviews, observations and a survey to address the following five topics: organisational structure and supporting technology; leadership; teamwork; decision-making, perceived value and motivation. Thirteen persons with different tumour specialities and levels of seniority were interviewed. The 12 MDTMs were observed twice by uninvolved persons and evaluated by the participating physicians with a survey.
There were no systematic differences between MDTMs for different tumour types with the exception of the non-disease specific type MDTM, which was the only one for which the organisational structure was not driven by an electronic tool. However, several factors could be identified that generally influenced the functioning of the MDTMs. In particular, the quality of decision-making was highly dependent on the availability of case-based information and the presence of relevant cancer disease specialists. Leadership and teamwork were rated as important and were comparable across the MDTM. Team participants' motivation and perceived value of MDTMs was high across all meetings.
MDTM at a single institution did not demonstrate disease specific characteristics. An effective MDTM, irrespective of the tumour type, can be successfully structured by technical means and a chairperson coordinating the interaction of cancer disease specialists to improve the decision-making process.
多学科治疗是癌症中心的关键,所有癌症疾病专家在决策过程中的相互作用是最先进的。
描述不同肿瘤类型的 MDTM 的差异。
在一家三级医院,通过探索性顺序混合方法,结合访谈、观察和调查,评估了 12 次多学科团队会议(MDTMs),涉及不同癌症疾病专家的参与,以解决以下五个主题:组织结构和支持技术;领导力;团队合作;决策、感知价值和动机。采访了 13 名具有不同肿瘤专业知识和资历的人。对 12 次 MDTM 进行了两次由非参与人员观察,并由参与医生进行了一次调查评估。
除了非特定疾病类型的 MDTM 外,不同肿瘤类型的 MDTM 之间没有系统差异,后者是唯一一种其组织结构不受电子工具驱动的 MDTM。然而,有几个因素可以确定,这些因素通常会影响 MDTM 的功能。特别是,决策的质量高度依赖于基于案例的信息的可用性和相关癌症疾病专家的存在。领导力和团队合作被评为重要因素,在 MDTM 中是可比的。团队参与者对 MDTM 的积极性和感知价值在所有会议中都很高。
单一机构的 MDTM 没有表现出特定疾病的特征。一种有效的 MDTM,无论肿瘤类型如何,都可以通过技术手段和协调癌症疾病专家互动的主席成功构建,以改善决策过程。