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Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings

INTRODUCTION: Nowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSS...

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Autores principales: Walraven, Janneke E. W., Verhoeven, Rob H. A., van der Hoeven, Jacobus J. M., van der Meulen, Renske, Lemmens, Valery E. P. P., Hesselink, Gijs, Desar, Ingrid M. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233094/
https://www.ncbi.nlm.nih.gov/pubmed/37274246
http://dx.doi.org/10.3389/fonc.2023.1178165
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author Walraven, Janneke E. W.
Verhoeven, Rob H. A.
van der Hoeven, Jacobus J. M.
van der Meulen, Renske
Lemmens, Valery E. P. P.
Hesselink, Gijs
Desar, Ingrid M. E.
author_facet Walraven, Janneke E. W.
Verhoeven, Rob H. A.
van der Hoeven, Jacobus J. M.
van der Meulen, Renske
Lemmens, Valery E. P. P.
Hesselink, Gijs
Desar, Ingrid M. E.
author_sort Walraven, Janneke E. W.
collection PubMed
description INTRODUCTION: Nowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSSs) are two major ways to restructure MDTMs. Streamlining is the process of selecting the patients who need to be discussed and in which type of MDTM. Using CCDSSs, patient data is automatically loaded into the minutes and a guideline-based treatment proposal is generated. We aimed to identify the pros and cons of streamlining and CCDSSs. METHODS: Semi-structured interviews were conducted with Dutch MDTM participants. With purposive sampling we maximised variation in participants’ characteristics. Interview data were thematically analysed. RESULTS: Thirty-five interviews were analysed. All interviewees agreed on the need to change the current MDTM workflow. Streamlining suggestions were thematised based on standard and complex cases and the location of the MDTM (i.e. local, regional or nationwide). Interviewees suggested easing the pressure on MDTMs by discussing standard cases briefly, not at all, or outside the MDTM with only two to three specialists. Complex cases should be discussed in tumour-type-specific regional MDTMs and highly complex cases by regional/nationwide expert teams. Categorizing patients as standard or complex was found to be the greatest challenge of streamlining. CCDSSs were recognised as promising, although none of the interviewees had made use of them. The assumed advantage was their capacity to generate protocolised treatment proposals based on automatically uploaded patient data, to unify treatment proposals and to facilitate research. However, they were thought to limit the freedom to deviate from the treatment advice. CONCLUSION: To make oncological MDTMs sustainable, methods of streamlining should be developed and introduced. Physicians still have doubts about the value of CCDSSs.
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spelling pubmed-102330942023-06-02 Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings Walraven, Janneke E. W. Verhoeven, Rob H. A. van der Hoeven, Jacobus J. M. van der Meulen, Renske Lemmens, Valery E. P. P. Hesselink, Gijs Desar, Ingrid M. E. Front Oncol Oncology INTRODUCTION: Nowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSSs) are two major ways to restructure MDTMs. Streamlining is the process of selecting the patients who need to be discussed and in which type of MDTM. Using CCDSSs, patient data is automatically loaded into the minutes and a guideline-based treatment proposal is generated. We aimed to identify the pros and cons of streamlining and CCDSSs. METHODS: Semi-structured interviews were conducted with Dutch MDTM participants. With purposive sampling we maximised variation in participants’ characteristics. Interview data were thematically analysed. RESULTS: Thirty-five interviews were analysed. All interviewees agreed on the need to change the current MDTM workflow. Streamlining suggestions were thematised based on standard and complex cases and the location of the MDTM (i.e. local, regional or nationwide). Interviewees suggested easing the pressure on MDTMs by discussing standard cases briefly, not at all, or outside the MDTM with only two to three specialists. Complex cases should be discussed in tumour-type-specific regional MDTMs and highly complex cases by regional/nationwide expert teams. Categorizing patients as standard or complex was found to be the greatest challenge of streamlining. CCDSSs were recognised as promising, although none of the interviewees had made use of them. The assumed advantage was their capacity to generate protocolised treatment proposals based on automatically uploaded patient data, to unify treatment proposals and to facilitate research. However, they were thought to limit the freedom to deviate from the treatment advice. CONCLUSION: To make oncological MDTMs sustainable, methods of streamlining should be developed and introduced. Physicians still have doubts about the value of CCDSSs. Frontiers Media S.A. 2023-05-18 /pmc/articles/PMC10233094/ /pubmed/37274246 http://dx.doi.org/10.3389/fonc.2023.1178165 Text en Copyright © 2023 Walraven, Verhoeven, van der Hoeven, van der Meulen, Lemmens, Hesselink and Desar https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Walraven, Janneke E. W.
Verhoeven, Rob H. A.
van der Hoeven, Jacobus J. M.
van der Meulen, Renske
Lemmens, Valery E. P. P.
Hesselink, Gijs
Desar, Ingrid M. E.
Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
title Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
title_full Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
title_fullStr Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
title_full_unstemmed Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
title_short Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
title_sort pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233094/
https://www.ncbi.nlm.nih.gov/pubmed/37274246
http://dx.doi.org/10.3389/fonc.2023.1178165
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