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A Digital Solution for an Advanced Breast Tumor Board: Pilot Application Cocreation and Implementation Study.

作者信息

Hodroj Khalil, Pellegrin David, Menard Cindy, Bachelot Thomas, Durand Thierry, Toussaint Philippe, Dufresne Armelle, Mery Benoite, Tredan Olivier, Goulvent Thibaut, Heudel Pierre

机构信息

Centre Leon Berard, Lyon, France.

Roche Healthcare Development Division - Roche Diagnostics France, Meylan, Meylan, France.

出版信息

JMIR Cancer. 2023 May 18;9:e39072. doi: 10.2196/39072.


DOI:10.2196/39072
PMID:37200077
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10236276/
Abstract

BACKGROUND: Cancer treatment is constantly evolving toward a more personalized approach based on clinical features, imaging, and genomic pathology information. To ensure the best care for patients, multidisciplinary teams (MDTs) meet regularly to review cases. Notwithstanding, the conduction of MDT meetings is challenged by medical time restrictions, the unavailability of critical MDT members, and the additional administrative work required. These issues may result in members missing information during MDT meetings and postponed treatment. To explore and facilitate improved approaches for MDT meetings in France, using advanced breast cancers (ABCs) as a model, Centre Léon Bérard (CLB) and ROCHE Diagnostics cocreated an MDT application prototype based on structured data. OBJECTIVE: In this paper, we want to describe how an application prototype was implemented for ABC MDT meetings at CLB to support clinical decisions. METHODS: Prior to the initiation of cocreation activities, an organizational audit of ABC MDT meetings identified the following four key phases for the MDT: the instigation, preparation, execution, and follow-up phases. For each phase, challenges and opportunities were identified that informed the new cocreation activities. The MDT application prototype became software that integrated structured data from medical files for the visualization of the neoplastic history of a patient. The digital solution was assessed via a before-and-after audit and a survey questionnaire that was administered to health care professionals involved in the MDT. RESULTS: The ABC MDT meeting audit was carried out during 3 MDT meetings, including 70 discussions of clinical cases before and 58 such discussions after the implementation of the MDT application prototype. We identified 33 pain points related to the preparation, execution, and follow-up phases. No issues were identified related to the instigation phase. Difficulties were grouped as follows: process challenges (n=18), technological limitations (n=9), and the lack of available resources (n=6). The preparation of MDT meetings was the phase in which the most issues (n=16) were seen. A repeat audit, which was undertaken after the implementation of the MDT application, demonstrated that (1) the discussion times per case remained comparable (2 min and 22 s vs 2 min and 14 s), (2) the capture of MDT decisions improved (all cases included a therapeutic proposal), (3) there was no postponement of treatment decisions, and (4) the mean confidence of medical oncologists in decision-making increased. CONCLUSIONS: The introduction of the MDT application prototype at CLB to support the ABC MDT seemed to improve the quality of and confidence in clinical decisions. The integration of an MDT application with the local electronic medical record and the utilization of structured data conforming to international terminologies could enable a national network of MDTs to support sustained improvements to patient care.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e31d/10236276/29c0fd392421/cancer_v9i1e39072_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e31d/10236276/29c0fd392421/cancer_v9i1e39072_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e31d/10236276/29c0fd392421/cancer_v9i1e39072_fig1.jpg

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A Digital Solution for an Advanced Breast Tumor Board: Pilot Application Cocreation and Implementation Study.

JMIR Cancer. 2023-5-18

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引用本文的文献

[1]
The Use of an Integrated Digital Tool to Improve the Efficiency of Multidisciplinary Tumor Boards-A Prospective Trial in Taiwan.

Cancers (Basel). 2025-1-28

[2]
Mixed Reality as a Digital Visualisation Solution for the Head and Neck Tumour Board: Application Creation and Implementation Study.

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本文引用的文献

[1]
An Integrated Care Platform System (C3-Cloud) for Care Planning, Decision Support, and Empowerment of Patients With Multimorbidity: Protocol for a Technology Trial.

JMIR Res Protoc. 2022-7-13

[2]
Multidisciplinary team meeting as a highly recommended EUSOMA criteria evaluating the quality of breast cancer management between centers.

Breast. 2021-12

[3]
Multidisciplinary team meetings: are all patients presented and does it impact quality of care and survival - a registry-based study.

BMC Health Serv Res. 2021-10-1

[4]
A Smartphone-Based App to Improve Adjuvant Treatment Adherence to Multidisciplinary Decisions in Patients With Early-Stage Breast Cancer: Observational Study.

J Med Internet Res. 2021-9-16

[5]
Prognostic impact of HER2-low expression in hormone receptor positive early breast cancer.

Breast. 2021-12

[6]
The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review.

Cancers (Basel). 2021-8-18

[7]
Ribociclib plus fulvestrant for postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer in the phase III randomized MONALEESA-3 trial: updated overall survival.

Ann Oncol. 2021-8

[8]
Trastuzumab Deruxtecan: Changing the Destiny of HER2 Expressing Solid Tumors.

Int J Mol Sci. 2021-4-30

[9]
OSIRIS: A Minimum Data Set for Data Sharing and Interoperability in Oncology.

JCO Clin Cancer Inform. 2021-3

[10]
Long-Term Pooled Safety Analysis of Palbociclib in Combination with Endocrine Therapy for Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: Updated Analysis with up to 5 Years of Follow-Up.

Oncologist. 2021-5

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