University Hospitals Sussex NHS Foundation Trust, Brighton, Sussex, UK.
Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
BMC Health Serv Res. 2024 Nov 27;24(1):1481. doi: 10.1186/s12913-024-11984-z.
Cancer multi-disciplinary team meetings (MDTM) assemble clinical experts to make diagnostic and treatment recommendations. MDTMs can take place in person, virtually, or in a hybrid format. Virtual and hybrid MDTMs have been in use for over two decades. This systematic scoping review aims to map the evidence on virtual and hybrid MDTM formats over time, providing insights into their quality, and the facilitators and barriers to their effective delivery.
The PRISMA scoping review checklist has been followed. A systematic search of PubMed, PsychINFO, and Embase between 1990-2023 identified 9399 records. These were independently screened by two researchers to identify primary research of any design that assessed quality or effectiveness of cancer VMDTMs. Results were narratively synthesised.
Eight quantitative, two qualitative and three mixed-methods studies were included. All were observational and most were retrospective (n = 8). Varied outcome measures were used to evaluate meeting quality, including treatment recommendations, survival, time from diagnosis, and overall attendance. VMDTMs were superior (N = 6) or sometimes equivalent (N = 4) to face-to-face meetings. Studies identified implementation factors critical to their effective delivery, including internet-stability and chairing.
The heterogeneous literature suggests VMDTMs offer some benefits over face-to-face meetings. Training and infrastructure are key to prevent risks to patient safety. A definitive comparative evaluation is needed to inform best practice.
癌症多学科团队会议(MDTM)汇集了临床专家,以提出诊断和治疗建议。MDTM 可以亲自、虚拟或混合形式进行。虚拟和混合 MDTM 已经使用了二十多年。本系统范围综述旨在随着时间的推移绘制关于虚拟和混合 MDTM 格式的证据图,深入了解其质量,以及有效实施的促进因素和障碍。
遵循 PRISMA 范围审查清单。1990 年至 2023 年间,在 PubMed、PsychINFO 和 Embase 中进行了系统搜索,确定了 9399 条记录。这些记录由两名研究人员独立筛选,以确定任何设计的主要研究,评估癌症 VMDTM 的质量或有效性。结果进行了叙述性综合。
纳入了 8 项定量研究、2 项定性研究和 3 项混合方法研究。所有研究都是观察性的,大多数是回顾性的(n=8)。使用不同的结果测量来评估会议质量,包括治疗建议、生存率、从诊断到治疗的时间以及整体出席率。VMDTM 优于(n=6)或有时等同于(n=4)面对面会议。研究确定了对其有效实施至关重要的实施因素,包括互联网稳定性和主席角色。
异质文献表明,VMDTM 相对于面对面会议提供了一些优势。培训和基础设施是预防患者安全风险的关键。需要进行明确的比较评估,以为最佳实践提供信息。