Quality insurance in head and neck cancer multidisciplinary team meetings: A watchful eye on real-life experience

Guy, Jean‐Baptiste; Benna, Marouan; Xia, Yaoxiong; Daguenet, Élisabeth; Mrad, Majed Ben; Jmour, Omar; Vial, Nicolas; Lelonge, Yann; Fournel, P.; Prades, Jean-Michel; Vallard, Alexis; Magné, Nicolas

doi:10.1016/j.oraloncology.2019.02.020

Cited by 7 publications

(10 citation statements)

References 22 publications

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“…The importance of MDTs and their impact on outcomes is increasingly investigated and recognized [38][39][40][41]. Their implementation and optimization have been submitted to study [39,42,43]. MDTs have been associated with improved efficiency and completeness of care [44].…”

Section: Multidisciplinary Teams Integrated Carementioning

confidence: 99%

Value and Quality of Care in Head and Neck Oncology

et al. 2020

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Purpose of Review The concept of value-based health care (VBHC) was articulated more than a decade ago. However, its clinical implementation remains an ongoing process and a particularly demanding one for the domain of head and neck cancer (HNC). These cancers often present with fast growing tumors in functionally and cosmetically sensitive sites and afflict patients with differing circumstances and comorbidity. Moreover, the various treatment modalities and protocols have different effects on functional outcomes. Hence, the interpretation of what constitutes VBHC in head and neck oncology remains challenging. Recent Findings This monograph reviews developments in specific aspects of VBHC for HNC patients, including establishment of registries and quality indices (such as infrastructure, process, and outcome indicators). It emphasizes the importance of the multidisciplinary team, "time to treatment intervals," and adherence to guidelines. The discussion addresses major indicators including survival, quality of life and functional outcomes, and adverse events. Also, strengths and weaknesses of nomograms, prognostic and decision models, and variation of care warrant attention. Summary Health care professionals, together with patients, must properly define quality and relevant outcomes, both for the individual patient as well as the HNC population. It is essential to capture and organize the relevant data so that they can be analyzed and the results used to improve both outcomes and value. Keywords Head and neck. Cancer. Quality of care. Indicators. Value-based health care This article was written by members and invitees of the International Head and Neck Scientific Group (www.IHNSG.com). This article is part of the Topical Collection on Head and Neck Cancers.

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Section: Multidisciplinary Teams Integrated Carementioning

confidence: 99%

Value and Quality of Care in Head and Neck Oncology

et al. 2020

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“…Guy et al 2019reported a high number of uniquely discussed cases suggesting that recurrent cases are not routinely discussed. In some cases, surgery had been performed prior to the MDT meeting (Guy et al, 2019). Overall, the presence of experts in the field in a MDT…”

Section: Impact Of Disease-free Intervalmentioning

confidence: 99%

“…In the recurrent/ salvage setting, there is still room for improvement. Guy et al (2019) reported a high number of uniquely discussed cases suggesting that recurrent cases are not routinely discussed. In some cases, surgery had been performed prior to the MDT meeting (Guy et al., 2019).…”

Section: Prognosticators In Salvage Surgerymentioning

confidence: 99%

“…Guy et al (2019) reported a high number of uniquely discussed cases suggesting that recurrent cases are not routinely discussed. In some cases, surgery had been performed prior to the MDT meeting (Guy et al., 2019). Overall, the presence of experts in the field in a MDT leads to implication of current and novel evidence‐based treatments, reduced time to treatment and enrolment in clinical trials for patients in the metastatic and recurrent setting not eligible for curative treatment.…”

Section: Prognosticators In Salvage Surgerymentioning

confidence: 99%

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Salvage surgery in head and neck cancer

Weert

Leemans

2020

Oral Diseases

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Salvage surgery in Head and Neck Cancer (HNC) after failed (chemo) radiotherapy is a complex and increasingly important issue with high stakes for the patients. Patients eligible for SS have previously been through the process of HNC treatment with accompanying anxiety and uncertainties. Therefore, they should be guided accordingly and informed in a truthful and concise manner meaning that salvage surgery is a last resort treatment with an often uncertain outcome both considering cure and function impacting quality of life. Salvage surgery should never be considered a fall back option in case patients elect organ preservation treatment over an advised primary surgical treatment. Performing surgery in previously irradiated tissue, especially when combined with systemic treatment enhancing toxicity, is a very difficult and comes with many both short-and long-term complications. Although surgical and radiation techniques have improved, salvage surgery remains a journey not easily embarked on with current success rates often not exceeding 30%. This paper sets out to give an overview of current literature with regard to prognosticators in salvage surgery in light of developments such as increasing incidence of human papillomavirus in oropharyngeal squamous cell carcinoma, the use of transoral robotic surgery, necessity of multidisciplinary management and the increasing awareness for value-based health care. 2 | E VOLVEMENT OF SALVAG E SURG ERY Although salvage surgery has always played a role in HNC, its prospects have changed over the last decades with the introduction of combined modality treatment for advanced stage disease. The use of mainly cisplatin and later cetuximab in platinum unfit patients has added toxicity causing bigger challenges for uneventful outcome in

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“…A recent systematic review of studies addressing the organization of MDTs identified data issues, including quality of facilities, online and computing needs, and administrative support . Other MDT data‐related topics investigated in a range of tumor streams include gaps in comorbidity data, standardized reporting to general practitioners, possible deficiencies in collection of patient‐related factors, and optimal timing of MDT presentation …”

Section: Introductionmentioning

confidence: 99%

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

Rankin

Vinod

Nagarajah

et al. 2019

Asia-Pac J Clncl Oncology

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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

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Quality insurance in head and neck cancer multidisciplinary team meetings: A watchful eye on real-life experience

Cited by 7 publications

References 22 publications

Value and Quality of Care in Head and Neck Oncology

Value and Quality of Care in Head and Neck Oncology

Salvage surgery in head and neck cancer

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

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