Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study

Abstract

Aim: Multidisciplinary team (MDT) meetings can facilitate optimal lung cancer care, yet details of structured data collection and feedback remain sparse. This study aimed to investigate data collection and the impact of feedback to lung cancer MDTs. Methods:A mixed-methods study using pre and post-test surveys, semistructured interviews, and observation to evaluate data collection and response to modeled data feedback in three Australian lung cancer MDTs at different locations and development stage (site A: outer metropolitan, established; site B, outer metropolitan, new; and site C, inner metropolitan, established). Results: MDT attendees (range 13-25) discussed 5-8 cases per meeting. All sites collected data prospectively (80% prepopulated) into local oncology medical information systems. The pretest survey had 17 respondents in total (88% clinicians). At sites A and C, 100% of respondents noted regular data audits, occasional at site B. Regular audit data included number of cases, stage, final diagnosis, and time to diagnosis and treatment. The post-test survey had 25 respondents in total, all clinicians. The majority (88-96%) of respondents found modeled data easy to interpret, relevant to clinical practice and the MDT, and welcomed future regular data presentations (as rated on a 5-point Likert scale mean weighted average 4.5 where > 4 demonstrates agreement). Semistructured interviews identified five major themes for MDTs: current practice, attitudes, enablers, barriers, and benefits for the MDT.Conclusions: MDT teams exhibited positive responses to modeled data feedback. Key characteristics of MDT data were identified and may assist with future team research and development. K E Y W O R D S data feedback, data quality, health data, lung neoplasm, multidisciplinary teams Asia-Pac J Clin Oncol. 2020;16:45-55. c

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

“…Data feedback of recommendations is another important issue. Stone et al reported a mixed-methods study on the clinical impact of modeled data feedback at a lung cancer MTD based on pre-and post-surveys and semi-structured interviews at three Australian cancer centers [35]. Results demonstrated agreement if they reached C 4 values on a five-point Likert scale.…”

“…The quality of decisionmaking in MTD depends on the quality of records presented and team processes quality. Medical literature reports that MTD usually discusses 5-8 cases per meeting [35]. German investigators employed an adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) to assess the quality of the presented information and team processes in 249 cases discussed at 29 MTBs [37].…”

Optimizing lung cancer MDT data for maximum clinical impact—a scoping literature review

“…The proliferation of MDT-related research papers over recent years indicates a strong interest in MDT practice. Research from our group has identified positive responses from MDT clinicians to modelled data feedback, representing their own clinical cohorts (43).…”

“…National lung cancer audits such as in the UK above, Denmark (44) and the Netherlands (16,45) demonstrate the effects of systems that include institutional data feeds into national registries, portals for feedback and subsequent benchmarking. Smaller scale studies have tested details of audit and feedback to clinicians both in lung cancer (43,46) and other fields (47) but there is little if any (to our knowledge) literature on the effects of real-time, clinical data feedback to lung cancer MDTs on clinical outcomes. Cancer outcomes data are often delayed, even in this series of papers with an average of over four years between the data collection period and publication of the paper.…”

European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Lung cancer

“…MDT performance must be quality assured both internally and by external review with demonstration of cost-effectiveness of quality improvements, and MDT guidance must be promoted nationally and written into national cancer plans. The use of tools and data feedback to improve MDT performance should be considered [174,175]. • The ERQCC expert group strongly recommends that further attention be given to measures of patient reported outcomes, not only to agree which tools should be used, but also to use them more systematically as part of discussions and evaluation within the MDT.…”