Development and validation of a short version of the Metric for the Observation of Decision-making in multidisciplinary tumor boards: MODe-Lite

Abstract

Background: Evidence-based tools are necessary for scientifically improving the way cancer multidisciplinary tumor boards (MTBs) work. Such tools are available but can be difficult to use. We sought to develop a robust observational assessment tool for use by healthcare professionals to improve how MTBs work in everyday practice.Participants and methods: We conducted a retrospective cross-sectional observational study in the United Kingdom between September 2015 and July 2016. Three tumor boards from three teaching hospitals were recruited with 44 members overall. Six weekly meetings (146 consecutive cases) were video recorded and scored using the validated MODe tool. Data were subjected to reliability and validity analysis in the current study for the purposes of developing a shorter version of MODe.Results: In phase 1, a reduction in the original items of MODe was achieved through two focus group meetings with expert assessors based on previous research. Twelve original items were reduced to six domains and have received full agreement by the assessors. In Phase 2, the six domains were subjected to item reliability, convergent validation, and internal consistency testing against MODe-Lite global score, MODe global score, and the individual items of MODe. Significant positive correlations were evidenced across the six domains (p<0.01), providing indication of good reliability and validity. In phase 3, feasibility and high inter-assessor reliability in the use of the tool by two clinical assessors was achieved. A final set of 6 domains, measuring clinical input, holistic input, clinical collaboration, pathology, radiology and management plan were integrated into MODe-Lite.Conclusions: MODe-Lite is an evidence-based tool that can be used by healthcare professionals in everyday practice. It can give cancer MTBs insight into the way they work to facilitate improvements in practice.

The cancer multidisciplinary team meeting: in need of change? History, challenges and future perspectives

“…Several evidence‐based tools for the assessment and improvement of the performance of MDTs (Table 1; [11–19]) have been developed. These tools can be used by clinicians, administrators, or researchers to gain an objective understanding of how their teams are performing.…”

ASO Author Reflections: The Pursuit of Digitalised Quality Improvement Assessment Tools for Cancer Multidisciplinary Teams

“…This was developed with a focus on assessing and improving MTBs’ decision-making and teamwork, but it can be cumbersome for use in routine clinical practice by healthcare staff. 4 We set out to modify the MODe tool so that it could more readily be used by MTBs interested in assessing and improving the way they work. 5 …”