caa a22 4500 44533620X CHVBK 20180317142756.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1675-6 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1675-6 Quality of Care Management Decisions by Multidisciplinary Cancer Teams: A Systematic Review [Elektronische Daten] [Benjamin Lamb, Katrina Brown, Kamal Nagpal, Charles Vincent, James Green, Nick Sevdalis] Background: Factors that affect the quality of clinical decisions of multidisciplinary cancer teams (MDTs) are not well understood. We reviewed and synthesised the evidence on clinical, social and technological factors that affect the quality of MDT clinical decision-making. Methods: Electronic databases were searched in May 2009. Eligible studies reported original data, quantitative or qualitative. Data were extracted and tabulated by two blinded reviewers, and study quality formally evaluated. Results: Thirty-seven studies were included. Study quality was low to medium. Studies assessed quality of care decisions via the effect of MDTs on care management. MDTs changed cancer management by individual physicians in 2-52% of cases. Failure to reach a decision at MDT discussion was found in 27-52% of cases. Decisions could not be implemented in 1-16% of cases. Team decisions are made by physicians, using clinical information. Nursing personnel do not have an active role, and patient preferences are not discussed. Time pressure, excessive caseload, low attendance, poor teamworking and lack of leadership lead to lack of information and deterioration of decision-making. Telemedicine is increasingly used in developed countries, with no detriment to quality of MDT decisions. Conclusions: Team/social factors affect management decisions by cancer MDTs. Inclusion of time to prepare for MDTs into team-members' job plans, making team and leadership skills training available to team-members, and systematic input from nursing personnel would address some of the current shortcomings. These improvements ought to be considered at national policy level, with the ultimate aim of improving cancer care. Society of Surgical Oncology, 2011 Lamb Benjamin Department of Surgery and Cancer, Imperial College London, London, UK aut Brown Katrina Department of Surgery and Cancer, Imperial College London, London, UK aut Nagpal Kamal Department of Surgery and Cancer, Imperial College London, London, UK aut Vincent Charles Department of Surgery and Cancer, Imperial College London, London, UK aut Green James Department of Urology, Whipps Cross University Hospital, London, UK aut Sevdalis Nick Department of Surgery and Cancer, Imperial College London, London, UK aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2116-2125 1068-9265 18:8<2116 2011 18 10434 https://doi.org/10.1245/s10434-011-1675-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1675-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lamb Benjamin Department of Surgery and Cancer, Imperial College London, London, UK aut NATIONALLICENCE 700 1- Brown Katrina Department of Surgery and Cancer, Imperial College London, London, UK aut NATIONALLICENCE 700 1- Nagpal Kamal Department of Surgery and Cancer, Imperial College London, London, UK aut NATIONALLICENCE 700 1- Vincent Charles Department of Surgery and Cancer, Imperial College London, London, UK aut NATIONALLICENCE 700 1- Green James Department of Urology, Whipps Cross University Hospital, London, UK aut NATIONALLICENCE 700 1- Sevdalis Nick Department of Surgery and Cancer, Imperial College London, London, UK aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2116-2125 1068-9265 18:8<2116 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer