scholarly journals The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4159
Author(s):  
Lejla Kočo ◽  
Harm H. A. Weekenstroo ◽  
Doenja M. J. Lambregts ◽  
J. P. Michiel Sedelaar ◽  
Mathias Prokop ◽  
...  
Keyword(s):  
Systematic Review ◽  
Multidisciplinary Team ◽  
Heterogeneous Data ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Team Meetings ◽  
Process Outcomes ◽  
Management Plans ◽  
The Impact ◽  
Multidisciplinary Team Meetings

Objective: The aim of our systematic review is to identify the effects of multidisciplinary team meetings (MDTM) for lung, breast, colorectal and prostate cancer. Methods: Our systematic review, performed following PRISMA guidelines, included studies examining the impact of MDTMs on treatment decisions, patient and process outcomes. Electronic databases PUBMED, EMBASE, Cochrane Library and Web of Science were searched for articles published between 2000 and 2020. Risk of bias and level of evidence were assessed using the ROBINS-I tool and GRADE scale. Results: 41 of 13,246 articles were selected, evaluating colorectal (21), lung (10), prostate (6) and breast (4) cancer. Results showed that management plans were changed in 1.6–58% of cases after MDTMs. Studies reported a significant impact of MDTMs on surgery type, and a reduction of overall performed surgery after MDTM. Results also suggest that CT and MRI imaging significantly increased after MDTM implementation. Survival rate increased significantly with MDTM discussions according to twelve studies, yet three studies did not show significant differences. Conclusions: Despite heterogeneous data, MDTMs showed a significant impact on management plans, process outcomes and patient outcomes. To further explore the impact of MDTMs on the quality of healthcare, high-quality research is needed.

scholarly journals Impact of the COVID-19 pandemic urology trainees in the West of Scotland

2021 ◽  
pp. 205141582098767
Author(s):  
Ashley Carrera ◽  
Je Song Shin ◽  
Holly Bekarma
Keyword(s):  
Multidisciplinary Team ◽  
Online Teaching ◽  
The West ◽  
Level Of Evidence ◽  
Team Meetings ◽  
Educational Benefit ◽  
Teaching Modules ◽  
The Impact ◽  
Training Opportunities ◽  
Multidisciplinary Team Meetings

Hospitals worldwide have taken unprecedented steps to cope with the coronavirus disease 2019 (COVID-19) pandemic. Changes to services created challenges for delivering training in urology. Statutory education bodies implemented processes addressing trainee progression, but the extent of training disruption has not been quantified. To establish the impact on urology trainees in the West of Scotland, online questionnaires were sent to trainees and educational supervisors. Twenty-five trainees working at six hospitals across four health boards responded. Elective operating was significantly reduced, with 64% of trainees having no weekly sessions. Before the pandemic, the majority of trainees (92%) had one or two clinic sessions or more per week, but with new measures, 76% of trainees did not attend clinics. Trainee attendance at multidisciplinary team meetings halved during the pandemic. Sixteen per cent ( n=4) of trainees were redeployed, with 50% ( n=2) reporting no educational benefit. Commonly used alternative educational resources included webinars (52%) and online teaching modules (28%). Thirty-two per cent ( n=8) of trainees had examinations postponed. COVID-19 has impacted urology training in the West of Scotland, with a significant reduction in training opportunities across elective theatre, clinic exposure and education. However, trainees will be more adaptable, learn to work remotely, have opportunities to develop leadership and may help redesign services for the future of urology. Level of evidence: Not applicable.

scholarly journals Multidisciplinary team meetings: are all patients presented and does it impact quality of care and survival – a registry-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Quentin Rollet ◽  
Véronique Bouvier ◽  
Grégoire Moutel ◽  
Ludivine Launay ◽  
Anne-Laure Bignon ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Quality Of Care ◽  
Multidisciplinary Team ◽  
Poor Prognosis ◽  
Metastatic Cancer ◽  
Factors Associated ◽  
Team Meetings ◽  
The Impact ◽  
Multidisciplinary Team Meetings

Abstract Background Multidisciplinary team meetings (MDTMs) are part of the standard cancer care process in many European countries. In France, they are a mandatory condition in the authorization system for cancer care administration, with the goal to ensure that all new patients diagnosed with cancer are presented in MDTMs. Aim Identify the factors associated with non-presentation or unknown presentation in MDTMs, and study the impact of presentation in MDTMs on quality of care and survival in patients diagnosed with colorectal cancer (CRC). Methods 3999 CRC patients diagnosed between 2005 and 2014 in the area covered by the “Calvados Registry of Digestive Tumours” were included. Multivariate multinomial logistic regression was used to assess the factors associated with presentation in MDTMs. Univariate analyses were performed to study the impact of MDTMs on quality of care. Multivariate Cox model and the Log-Rank test were used to assess the impact of MDTMs on survival. Results Non-presentation or unknown presentation in MDTMs were associated with higher age at diagnosis, dying within 3 months after diagnosis, unknown metastatic status, non-metastatic cancer and colon cancer. Non-presentation was associated with a diagnosis after 2010. Unknown presentation was associated with a diagnosis before 2007 and a longer travel time to the reference care centres. Presentation in MDTMs was associated with more chemotherapy administration for patients with metastatic cancer and more adjuvant chemotherapy for patients with stage III colon cancer. After excluding poor prognosis patients, lower survival was significantly associated with higher age at diagnosis, unknown metastatic status or metastatic cancer, presence of comorbidities, rectal cancer and non-presentation in MDTMs (HR = 1.5 [1.1–2.0], p < 0.001). Conclusions Elderly and poor prognosis patients were less presented in MDTMs. Geriatric assessments before presentation in MDTMs were shown to improve care plan establishment. The 100% objective is not coherent if MDTMs are only to discuss diagnosis and curative cares. They could also be a place to discuss therapeutic limitations. MDTMs were associated with better treatment and longer survival. We must ensure that there is no inequity in presentation in MDTMs that could lead to a loss of chance for patients.

scholarly journals Improving outcomes in urological cancers: The impact of “multidisciplinary team meetings”

2005 ◽  
Vol 3 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Peter L. Acher ◽  
Anthony J. Young ◽  
Russell Etherington-Foy ◽  
Philip J. McCahy ◽  
Anthony M. Deane
Keyword(s):  
Multidisciplinary Team ◽  
Team Meetings ◽  
Urological Cancers ◽  
The Impact ◽  
Multidisciplinary Team Meetings

scholarly journals The impact of multidisciplinary team meetings(MDTMs) in cancer care:evidence from an umbrella review

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
EM Frisicale ◽  
D Cappa ◽  
P Cacciatore ◽  
E Carini ◽  
A Pezzullo ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Umbrella Review ◽  
Team Meetings ◽  
The Impact ◽  
Multidisciplinary Team Meetings

The impact of adrenal tumor multidisciplinary team meetings on clinical outcomes

Endocrine ◽  
2020 ◽  
Vol 69 (3) ◽  
pp. 519-525
Author(s):  
Hidenori Fukuoka ◽  
Katsumi Shigemura ◽  
Maki Kanzawa ◽  
Tomonori Kanda ◽  
Masaaki Yamamoto ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Multidisciplinary Team ◽  
Adrenal Tumor ◽  
Team Meetings ◽  
The Impact ◽  
Multidisciplinary Team Meetings

The impact of exogenous nitric oxide during cardiopulmonary bypass for cardiac surgery

Perfusion ◽  
2021 ◽  
pp. 026765912110148
Author(s):  
Joseph Mc Loughlin ◽  
Lorraine Browne ◽  
John Hinchion
Keyword(s):  
Nitric Oxide ◽  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Troponin I ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
High Quality Research ◽  
Low Cardiac Output Syndrome ◽  
The Impact

Objectives: Cardiac surgery using cardiopulmonary bypass frequently provokes a systemic inflammatory response syndrome. This can lead to the development of low cardiac output syndrome (LCOS). Both of these can affect morbidity and mortality. This study is a systematic review of the impact of gaseous nitric oxide (gNO), delivered via the cardiopulmonary bypass (CPB) circuit during cardiac surgery, on post-operative outcomes. It aims to summarise the evidence available, to assess the effectiveness of gNO via the CPB circuit on outcomes, and highlight areas of further research needed to develop this hypothesis. Methods: A comprehensive search of Pubmed, Embase, Web of Science and the Cochrane Library was performed in May 2020. Only randomised control trials (RCTs) were considered. Results: Three studies were identified with a total of 274 patients. There was variation in the outcomes measures used across the studies. These studies demonstrate there is evidence that this intervention may contribute towards cardioprotection. Significant reductions in cardiac troponin I (cTnI) levels and lower vasoactive inotrope scores were seen in intervention groups. A high degree of heterogeneity between the studies exists. Meta-analysis of the duration of mechanical ventilation, length of ICU stay and length of hospital stay showed no significant differences. Conclusion: This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations.

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