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Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance
OBJECTIVES: The cancer multidisciplinary team (MDT) meeting (MDM) is regarded as the best platform to reduce unwarranted variation in cancer care through evidence-compliant management. However, MDMs are often overburdened with many different agendas and hence struggle to achieve their full potential...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Group
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383983/ https://www.ncbi.nlm.nih.gov/pubmed/22734113 http://dx.doi.org/10.1136/bmjopen-2011-000439 |
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author | Patkar, Vivek Acosta, Dionisio Davidson, Tim Jones, Alison Fox, John Keshtgar, Mohammed |
author_facet | Patkar, Vivek Acosta, Dionisio Davidson, Tim Jones, Alison Fox, John Keshtgar, Mohammed |
author_sort | Patkar, Vivek |
collection | PubMed |
description | OBJECTIVES: The cancer multidisciplinary team (MDT) meeting (MDM) is regarded as the best platform to reduce unwarranted variation in cancer care through evidence-compliant management. However, MDMs are often overburdened with many different agendas and hence struggle to achieve their full potential. The authors developed an interactive clinical decision support system called MATE (Multidisciplinary meeting Assistant and Treatment sElector) to facilitate explicit evidence-based decision making in the breast MDMs. DESIGN: Audit study and a questionnaire survey. SETTING: Breast multidisciplinary unit in a large secondary care teaching hospital. PARTICIPANTS: All members of the breast MDT at the Royal Free Hospital, London, were consulted during the process of MATE development and implementation. The emphasis was on acknowledging the clinical needs and practical constraints of the MDT and fitting the system around the team's workflow rather than the other way around. Delegates, who attended MATE workshop at the England Cancer Networks' Development Programme conference in March 2010, participated in the questionnaire survey. OUTCOME MEASURES: The measures included evidence-compliant care, measured by adherence to clinical practice guidelines, and promoting research, measured by the patient identification rate for ongoing clinical trials. RESULTS: MATE identified 61% more patients who were potentially eligible for recruitment into clinical trials than the MDT, and MATE recommendations demonstrated better concordance with clinical practice guideline than MDT recommendations (97% of MATE vs 93.2% of MDT; N=984). MATE is in routine use in breast MDMs at the Royal Free Hospital, London, and wider evaluations are being considered. CONCLUSIONS: Sophisticated decision support systems can enhance the conduct of MDMs in a way that is acceptable to and valued by the clinical team. Further rigorous evaluations are required to examine cost-effectiveness and measure the impact on patient outcomes. The decision support technology used in MATE is generic and if found useful can be applied across medicine. |
format | Online Article Text |
id | pubmed-3383983 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BMJ Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-33839832012-06-28 Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance Patkar, Vivek Acosta, Dionisio Davidson, Tim Jones, Alison Fox, John Keshtgar, Mohammed BMJ Open Health Informatics OBJECTIVES: The cancer multidisciplinary team (MDT) meeting (MDM) is regarded as the best platform to reduce unwarranted variation in cancer care through evidence-compliant management. However, MDMs are often overburdened with many different agendas and hence struggle to achieve their full potential. The authors developed an interactive clinical decision support system called MATE (Multidisciplinary meeting Assistant and Treatment sElector) to facilitate explicit evidence-based decision making in the breast MDMs. DESIGN: Audit study and a questionnaire survey. SETTING: Breast multidisciplinary unit in a large secondary care teaching hospital. PARTICIPANTS: All members of the breast MDT at the Royal Free Hospital, London, were consulted during the process of MATE development and implementation. The emphasis was on acknowledging the clinical needs and practical constraints of the MDT and fitting the system around the team's workflow rather than the other way around. Delegates, who attended MATE workshop at the England Cancer Networks' Development Programme conference in March 2010, participated in the questionnaire survey. OUTCOME MEASURES: The measures included evidence-compliant care, measured by adherence to clinical practice guidelines, and promoting research, measured by the patient identification rate for ongoing clinical trials. RESULTS: MATE identified 61% more patients who were potentially eligible for recruitment into clinical trials than the MDT, and MATE recommendations demonstrated better concordance with clinical practice guideline than MDT recommendations (97% of MATE vs 93.2% of MDT; N=984). MATE is in routine use in breast MDMs at the Royal Free Hospital, London, and wider evaluations are being considered. CONCLUSIONS: Sophisticated decision support systems can enhance the conduct of MDMs in a way that is acceptable to and valued by the clinical team. Further rigorous evaluations are required to examine cost-effectiveness and measure the impact on patient outcomes. The decision support technology used in MATE is generic and if found useful can be applied across medicine. BMJ Group 2012-06-25 /pmc/articles/PMC3383983/ /pubmed/22734113 http://dx.doi.org/10.1136/bmjopen-2011-000439 Text en © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. |
spellingShingle | Health Informatics Patkar, Vivek Acosta, Dionisio Davidson, Tim Jones, Alison Fox, John Keshtgar, Mohammed Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
title | Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
title_full | Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
title_fullStr | Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
title_full_unstemmed | Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
title_short | Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
title_sort | using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance |
topic | Health Informatics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383983/ https://www.ncbi.nlm.nih.gov/pubmed/22734113 http://dx.doi.org/10.1136/bmjopen-2011-000439 |
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