Introduction
Methods
Results
Reference | Study design | Study characteristics | Themes and categories | ||||
---|---|---|---|---|---|---|---|
MDTM characteristics and logisticsa | Team culture | Decision makingb | Education | Evaluation and data collection | |||
Bate J. et al., 2019 [19] | Qualitative study | Type of MDTM: Ewing sarcoma (ES) Data collection method: survey and focus group N = 15 survey responders and 10 focus group participants of ES patients Period: October 2016 – January 2017 Country: United Kingdom | * I | ||||
Bohmeier B. et al., 2021 [20] | Qualitative study | Type of MDTM: breast cancer, gynaecological cancer Data collection method: semi-structured interviews N = 30 interviews to MDT-members (RR 28%) Period: June 2017 – May 2020 Country: Germany | * E | * HI | |||
Bolle S. et al., 2019 [21] | Prospective observational study | Type of MDTM: colorectal cancer Data collection method: MDTM observation N = 741 patient cases in 30 MDTMs observed Period: - Country: The Netherlands | * HI | ||||
Butow P. et al., 2007 [22] | Qualitative study | Type of MDTM: breast cancer Data collection method: survey N = 640 surveys to surgeons, nurses, patient advocates (RR 78%) Period: - Country: Australia | * E | ||||
Chaillou D. et al., 2019 [23] | Qualitative study | Type of MDTM: head and neck cancer Data collection method: survey N = 3 surveys in 54 patients (RR 63%) Period: December 2016 – March 2017 Country: France | * E | ||||
Choy E. et al., 2007 [24] | Qualitative study | Type of MDTM: breast cancer Data collection method: survey and interviews N = 30 patients participated at MDTM N = 17 participating health professionals Period: 2006 Australia | * I | ||||
Davison A. et al., 2004 [25] | Retrospective observational study | Type of MDTM: lung cancer Data collection method: analyse database N = 28 telemedicine MDTMs N = 62 patients Period: November 2000 – November 2001 Country: United Kingdom | * B | ||||
Delaney G. et al., 2004 [26] | Observational study | Type of MDTM: breast cancer Data collection method: N = 27 breast cancer specialists; survey before (RR 59%) and after (RR 62%) start videoconferencing Period: February 2000 – June 2000 Country: Australia | * B | * | |||
Devitt B. et al., 2010 [27] | Qualitative study | Type of MDTM: not specified Data collection method: focus groups N = 4 focus groups, in total 23 MDT-members Period: - Country: Australia | * E | * | * H | * | |
Dew K. et al., 2015 [12] | Prospective observational study + qualitative study | Type of MDTM: breast cancer, lung cancer, upper-gastro-intestinal cancers, colorectal cancer Data collection method: MDTM recording and content analysis N = 10 MDTMs audio recorded, 106 patients discussed Period: - Country: New Zealand | * H | ||||
Díez J. et al., 2019 [28] | Qualitative study | Type of MDTM: all Data collection method: survey N = 71 MDTM leaders Period: February 2017 – February 2018 Country: Spain | * | ||||
Evans L. et al., 2019 [29] | Qualitative study | Type of MDTM: all Data collection method: Survey and self-assessment N = 180 surveys / 19 MDTs (1stcycle), 118 surveys / 12 MDTs (2nd cycle) completed a self-assessment matrix Period: 2017 and 2018 Country: Australia | * | ||||
Evans L. et al., 2021 [30] | Qualitative study | Type of MDTM: all Data collection method: Survey and self-assessment N = 121 surveys (1stcycle, RR 52%), 118 surveys (2nd cycle, RR 52%), 146 surveys (3rd cycle, RR 65%) completed a self-assessment matrix Period: 2017, 2018, 2019 Country: Australia | * | ||||
Fahim C. et al., 2020 [31] | Qualitative study | Type of MDTM: all Data collection method: Interviews and focus groups N = 21 interviews with MDT-members N = 18 focus group participants (MDT-members) Period: April 2016 – July 2017 Country: Canada | * ABCDG | * | * H | * | |
Fahim C. et al., 2020 [32] | Prospective observational study | Type of MDTM: all Implementation of ‘Knowledge Training strategy’ Data collection method: MDTM observation N = 143 cases / 23 MDTMs (before phase) and 260 cases / 35 MDTMs (after phase) Period: - Country: Canada | * H | * | |||
Farrugia D. et al., 2015 [33] | Retrospective observational study | Type of MDTM: breast cancer Data collection method: analyse database RQRS = Rapid quality reporting system = web-based standardized documentation template based on national guidelines N = 140 patients in cohort of 10 weeks before start RQRS N = 142 patients in cohort 10 weeks after start RQRS Period: July – October 2013 Country: United States of America | * G | ||||
Field K. et al., 2010 [34] | Qualitative study | Type of MDTM: neuro-oncology Data collection method: survey N = 16 MDT-members (RR 100%) Period: July 2009 Country: Australia | * FG | ||||
Gandamihardja T. et al., 2019 [35] | Prospective observational study | Type of MDTM: breast cancer Data collection method: MDTM observation N = 346 cases Period:- Country: United Kingdom | * F | * | * | ||
Gatcliffe T. et al., 2008 [36] | Prospective observational study | Type of MDTM: gynaecological Data collection method: MDTM recording N = 52 MDTMs Period: May 2002 – August 2003 Country: United States of America | * | ||||
Hahlweg P. et al., 2015 [37] | Prospective observational study and qualitative study | Type of MDTM: all Data collection method: MDTM observation and content analysis and descriptive statistics N = 15 MDTMs observed Period: November – December 2013 Country: Germany | * G | * HI | * | ||
Hahlweg P. et al., 2017 [38] | Cross-sectional observational study | Type of MDTM: all Data collection method: MDTM observation N = 249 cases, 29 MDTMs Period: - Country: Germany | * I | ||||
Hamilton D. et al., 2016 [39] | Prospective observational study + qualitative study | Type of MDTM: head and neck cancers Data collection method: MDTM observation and ethnographic analyses N = 35 MDTMs and 37 MDT clinics observed; audio recorded and transcribed verbatim N = semi structured interviews with 20 patients and 9 MDTM staff members Period: - Country: United Kingdom | * I | ||||
Harris J. et al., 2014 [40] | Prospective observational study + qualitative study | Type of MDTM: all Data collection method: MDTM observation and interviews N = 20 MDTMs observed N = 64 team members, 19 peer observers interviews Period: - Country: United Kingdom | * | ||||
Harris J. et al., 2016 [41] | Prospective observational study | Type of MDTM: all Data collection method: MDTM observation N = 10 MDTMs, 13 health service staff observers, 1 clinical and 1 non-clinical observer Period: - Country: United Kingdom | * | ||||
Hoinvile L. et al., 2019 [42] | Qualitative study | Type of MDTM: all Data collection method: survey N = 1220 MDT-members Period: March – May 2017 Country: United Kingdom | * F | ||||
Huizen van S., et al. 2019 [43] | Prospective observational study + qualitative study | Type of MDTM: head and neck cancer Data collection method: MDTM observation and semi-structured interviews N = 6 interviews to MDT-members, N = 336 cases observed Period: - Country: The Netherlands | * F | ||||
Jalil R. et al., 2012 [44] | Qualitative study | Type of MDTM: all Data collection method: survey N = 265 MDT-coordinators Period: - Country: United Kingdom | * G | ||||
Jalil R. et al., 2013 [45] | Qualitative study | Type of MDTM: urology and gastroenterology Data collection method: interviews N = 22 MDTM members Period: - Country: United Kingdom | * BCE | * | * HI | ||
Jalil R. et al., 2014 [46] | Prospective observational study | Type of MDTM: urology Data collection method: MDTM observation N = 683 case discussions, 127 video recorded case discussions Period: - Country: United Kingdom | * | ||||
Janssen A. et al., 2018 [47] | Prospective observational study + qualitative study | Type of MDTM: all Data collection method: MDTM observation and semi-structured interviews N = 7 teams, 43 MDTMS N = 15 interviews Period: - Country: Australia | * BCG | * H | * | * | |
Jenkins V. et al., 2001 [48] | Qualitative study | Type of MDTM: breast cancer Data collection method: survey N = 64 MDT-members (RR 91%) Period: - Country: United Kingdom | * | * H | |||
Johnson C. et al., 2017 [49] | Qualitative study | Type of MDTM: All Data collection method: survey N = 3 MDTMs Period: - Country: Australia | * | ||||
Kunkler I. et al., 2006 [50] | Qualitative study | Type of MDTM: breast cancer Data collection method: survey N = 68 participants to Group behavior Inventory (GBI) survey: face-to-face GBI (RR 65%), post telemedicine GBI (RR 51%) Period: - Country: United Kingdom | * | *H | |||
Lamb B. et al., 2011 [51] | Qualitative study | Type of MDTM: all Data collection method: Semi-structured interviews N = 19 interviews with clinicians Period: October 2009 – April 2010 Country: United Kingdom | *ABCD | * | |||
Lamb B. et al., 2011 [52] | Prospective observational study + qualitative study | Type of MDTM: all Data collection method: MDTM observation and survey N = 164 cases observed, 67 surveys to MDT-members (RR 70%) Period: September – November 2009 Country: United Kingdom | * H | * | |||
Lamb B. et al., 2012 [53] | Qualitative study | Type of MDTM: All Data collection method: Survey N = 175 MDTM members Period: October 2010 – April 2011 Country: United Kingdom | * B | * H | |||
Lamb B. et al., 2013 [54] | Longitudinal observational study | Type of MDTM: urology Data collection method: N = 36 MDTMs, 1421 patients Multicomponent intervention: MDTM checklists before start, team training and written guidance Period: December 2009 – April 2011 Country: United Kingdom | * BC | * H | |||
Lamb B. et al., 2013 [55] | Prospective observational study | Type of MDTM: urology Data collection method: MDTM observation N = 7 MDTMs, assessing 298 cases Period: December 2009 – January 2010 Country: United Kingdom | * CDF | * H | |||
Lamb B. et al., 2013 [56] | Qualitative study | Type of MDTM: all Data collection method: survey N = 1636 surveys to MDT-members (RR 80%) Period: 2009 Country: United Kingdom | * AC | * I | |||
Lee Y. et al., 2017 [57] | Qualitative study | Type of MDTM: all Data collection method: survey N = 1000 MDT-members (RR 18%) Period:- Country: Korea | * D | * HI | |||
Lumenta D. et al., 2019 [58] | Observational Prospective observational study | Type of MDTM: all Data collection method: MDTM observation N = 27 MDTMs, 244 patients discussed Period: - Country: United Kingdom | * | ||||
Makaskill E. et al., 2006 [59] | Qualitative study | Type of MDTM: breast cancer Data collection method: survey N = 250 surveys to surgeons (RR 61%) Period: - Country: United Kingdom | * ACDFG | * | |||
Massoubre J. et al., 2018 [60] | Prospective observational study | Type of MDTM: head and neck cancer Data collection method: MDTM observation N = 119 patients Period: May – November 2014 Country: France | * E | ||||
Mullan B. et al., 2014 [61] | Prospective observational Study | Type of MDTM: head and neck cancer Data collection method: MDTM observation N = 10 MDTMs, N = 105 patients Period: January – September 2011 Country: United Kingdom | * F | ||||
Neri E. et al., 2021 [62] | Qualitative study | Type of MDTM: all Data collection method: survey N = 292 radiologists Period: 2018 Country: Germany | * C | ||||
Oeser A. et al., 2018 [63] | Qualitative study | Type of MDTM: head and neck cancer Data collection method: survey N = 8 clinical experts Period: - Country: Germany | * C | * H | |||
Ottevanger N. et al., 2013 [64] | Prospective observational study + qualitative study | Type of MDTM: all Data collection method: MDTM observation ans interviews N = 18 MDTMs, 15 chairs interviewed Period: January 2010 – April 2011 Country: The Netherlands | * ABCDG | ||||
Patkar V. et al., 2012 [65] | Qualitative study | Type of MDTM: breast cancer Data collection method: survey N = 1295 cases, 48 surveys (RR 89%) Period: - Country: United Kingdom | * H | * | |||
Pype P. et al., 2017 [66] | Qualitative study | Type of MDTM: all Data collection method: Semi-structured interviews N = 16 interviews with general practitioners Period: May–June 2014 Country: Belgium | * D | * H | |||
Rajasekaran R. et al., 2021 [67] | Qualitative study | Type of MDTM: sarcoma Data collection method: survey N = 39 MDT-members (RR 92%) Period: May 2020 Country: United Kingdom | * B | ||||
Rankin N. et al., 2017 [68] | Qualitative study | Type of MDTM: lung cancer Data collection method: survey N = 41 participants for documentation template development and implementation N = 492 surveys to general practitioners (RR 12%) | * G | ||||
Rankin N. et al., 2018 [69] | Qualitative study | Type of MDTM: lung cancer Data collection method: structured interviews and survey N = 492 surveys (RR 12%), 35 interviews with general practitioners Period: May 2014- May 2015 Country: Australia | * D | ||||
Robinson T. et al., 2017 [70] | Prospective observational study + qualitative study | Type of MDTM: all Data collection method: MDTM observation and semi-structured interviews N = 43 MDTMs observed, 18 interviews Period: 2013 Country: Australia | * CG | * H | * | ||
Rosell L. et al., 2018 [71] | Qualitative study | Type of MDTM: all Data collection method: survey N = participants of 50 MDTMs, 362 surveys (RR 67%) Period: - Country: Sweden | * C | * HI | |||
Salami A. et al., 2015 [72] | Retrospective cohort study | Type of MDTM: hepatocellular carcinoma Data collection method: analyse database N = 116 patients in total. N = 48 patients discussed through virtual MDTM | * B | ||||
Salloch S. et al., 2014 [73] | Prospective observational study + qualitative study | Type of MDTM: all Data collection method: MDTM observation N = 14 MDTMs, 136 cases Period: - Country: Germany | * I | ||||
Sarkar S. et al., 2014 [74] | Qualitative study | Type of MDTM: urological cancers Data collection method: Semi-structured interview N = 20 MDT-members Period: - Country: United Kingdom | * BC | * HI | |||
Scot R. et a, 2020 [75] | Cross-sectional observational study | Type of MDTM: gynaecological cancers Data collection method: MDTM observation N = 41 MDT case discussions Period: 6th – 29th March 2019 Country: United Kingdom | * I | * | * | ||
Shah S. et al., 2014 [76] | Prospective observational study | Type of MDTM: colorectal cancer Data collection method: N = 267 cases Period: - Country: United Kingdom | * | ||||
Snyder J. et al., 2017 [77] | Qualitative study | Type of MDTM: neuro-oncology Data collection method: survey N = 85 surveys to MDTM-chairs (RR 54%) Period: November 2015 – February 2016 Country: United States of America | * BD | * H | * | ||
Soukup T. et al., 2016 [78] | Cross-sectional observational study | Type of MDTM: breast cancer, lung cancer, colorectal cancer, urological cancers Data collection method: MDTM observation N = 1045 cases Period: 2010–2014 Country: United Kingdom | * C | ||||
Soukup T. et al., 2016 [79] | Prospective observational study | Type of MDTM: breast cancer, lung cancer, colorectal cancer, urological cancers Data collection method: MDTM observation N = 1045 cases Period: 2010–2014 Country: United Kingdom | * HI | ||||
Soukup T. et al., 2019 [80] | Longitudinal observational study | Type of MDTM: breast cancer Data collection method: MDTM observation N = 1355 cases reviewed Period: 2013 – 2015 Country: United Kingdom | * H | ||||
Soukup T. et al., 2020 [81] | Cross-sectional observational study | Type of MDTM: breast cancer, gynaecological cancers, colorectal cancer Data collection method: MDTM observation N = 30 MDTMs, 822 cases discussions, 44 MDT-members Period: September 2015 – July 2016 Country: United Kingdom | * H | ||||
Stone E. et al., 2018 [82] | Qualitative study | Type of MDTM: lung cancer Data collection method: survey + consensus conference (Delphi process) N = 350 survey’s round 1 (RR 35%), 98 surveys round 2 (RR 53%), 14 participants for consensus conference on MDTM dataset Period: - Country: Australia | * B | * H | |||
Stone E. et al., 2020 [83] | Qualitative study | Type of MDTM: lung cancer Data collection method: survey and interviews N = survey 1; 18 MDT-members, survey 2; 25 MDT-members, 6 semi-structured interviews Period: - Country: Australia | * | ||||
Taylor C. et al., 2012 [84] | Prospective observational study | Type of MDTM: colon cancer Data collection method: MDTM observation N = 10 MDTMs Period:- Country: United Kingdom | * | ||||
Taylor C. et al., 2012 [85] | Qualitative study | Type of MDTM: all Data collection method: survey N = 637 MDT-members (RR 52%) Period: - Country: United Kingdom | * | ||||
Taylor C. et al., 2021 [86] | Qualitative study | Type of MDTM: breast cancer Data collection method: interviews N = 36 interviews, 10 MDTMs Period: 2014 Country: United Kingdom | * | ||||
Vetto J. et al., 1996 [87] | Qualitative study | Type of MDTM: all Data collection method: survey N = 22 MDT-members (RR 100%) Period: 1990 – 1991 and 1992–1993 Country: United States of America | * F | ||||
Wallace I. et al., 2019 [88] | Prospective observational study + Qualitative study | Type of MDTM: gynaecological cancers, hematological cancers, skin cancers Data collection method: MDTM observation and thematic analysis of cases N = 122 MDTMs, 58 cases Period: - Country: United Kingdom | * H | ||||
Wihl J. et al., 2021 [89] | Prospective observational study | Type of MDTM: sarcoma, hepato-biliary cancer, neuro-oncology cancers Data collection method: MDTM observation N = 336 cases, 3 MDTMs Period: April 2019 – October 2019 Country: Sweden | * C | * I | |||
Wright F. et al., 2009 [90] | Qualitative study | Type of MDTM: all Data collection method: survey N = 385 MDT-members (RR 44%) Period: March 2007 – May 2007 Country: Canada | * D | ||||
Yuan Y. et al., 2018 [91] | Retrospective observational study | Type of MDTM: gastro intestinal cancers Data collection method: analyse database N = 3674 patients discussed in MDTMs Period: January 2015 – December 2016 Country: China | * BF | * H |
1. MDTMs should be routinely scheduled during working hours |
2. MDTMs should have a strict meeting discipline with structured presentation of information, projected imaging results and a structured discussion without interruptions. This could be included in written team guidance |
3. Ensure a clear agenda with timely availability of clinical results and protected time for the core members to prepare their cases |
4. Ensure attendance of all MDTM core members |
5. Establish an appropriate amount of time per case; streamlining of cases might be a way to achieve this |
6. Decisions made during MDTMs should be documented, preferably by an administrative support assistant using a standardised documentation template and during the meeting |
7. Pay attention to a good team culture and align tasks and responsibilities among MDT-members |
8. Enable structured representation of patient characteristics and preferences by the attending physician or clinical nurse specialist during the MDTM |
9. Make education an explicit goal of the MDTM for all team members and enable junior doctors to actively participate |
10. The process and functioning of MDTMs require structured evaluations. Several evaluation tools can be used for this, although none of these tools have proven to optimise MDTM functioning |
11. Data collected during MDTMs can be used for evaluating an MDTM’s own functioning and for additional purposes (e.g. epidemiological research) and this should be facilitated. Future developments should focus on computerized clinical support systems, to implement patient data, make guidelines-based recommendations or identify patients eligible for clinical trials |
MDTM characteristics and logistics
Schedule
Meeting discipline and circumstances
Preparation
Attendance
Patients attending MDTMs
Cases and streamlining
Administrative support
Team culture
Decision making
Decision-making process
Patient advocacy
Education
Evaluation and data collection
Name of Evaluation tool | Abbreviation | Execution | Scoring domains | Author |
---|---|---|---|---|
Multidisciplinary team maturity matrix | - | An annual member survey and a self-assessment tool to monitor team performance 5 domains are scored in 5 performance levels (basic to advanced, maximum matrix of 100 points) | Governance and leadership (including leadership, obligations of team members, decision-making, risk management) Meeting organization and logistics (including logistics and representation, pre-meeting, at meeting, post-meeting) Linkages and communication with general practitioners (GP’s) and patients (including access for GP’s, communication with GP’s (patients), information and education (general), patients) Data collection, analysis and research (including data collection, monitoring and evaluation, data quality and system integration, research) Infrastructure and human resources (including facilities and equipment, MDT co-ordination, care co-ordination, data management) | Evans L. et al., 2019 [29] |
Team Evaluation and Assessment Measure | - | 10 subdomains scored by observers each on a 10-point scale (1 very poor, 10 very good), including comments | Attendance, Leadership and chairing, Teamworking and culture, Personal development and training, Physical environment of meeting venue, Technology and equipment availability, Organization and administration, Post-meeting co-ordination of services, Patient-centered care, Clinical decision making processes | Harris J. et al., 2014 [40] |
Multidisciplinary team meeting observational tool | MDT-MODe; after adjustments MDT-MOT | 3 domains of teamworking scored by observers each on a 5-point scale (1 very poor, 5 very good) | Attendance Leadership/chairing of the MDT meeting Teamwork and culture | |
Peer review framework | - | 8 domains to assess MDT performance by peer-reviewers, scoring ‘under developed / developing / well developed’ | Structure and governance Membership and leadership Meeting organization and support Standards of care Patient involvement Quality assurance Professional development Financial governance | Johnson C. et al., 2017 [49] |
Team evaluation and assessment measure | TEAM | Multidisciplinary team self-assessment tool; survey with 47 items on 5 domains (17 subdomains) to be rated on 5-pont scale | Team (membership, attendance, leadership & chairing, teamworking & culture, Personal development & training) Infrastructure of meetings (physical environment of meeting venue, technology & equipment) Organization and administration for meetings (scheduling, preparation, prior to meetings, organization/administration during meeting, post-MDT meeting coordination of service) Patient-centered clinical decision making (who to discuss?, patient-centered care, clinical decision making process) Team governance (organization support, data collection, analysis & audit of outcomes, clinical governance) | Taylor C. et al., 2012 [85] |
Multidisciplinary team observational assessment rating scale | MDT-OARS | 4 domains with 15 aspects of MDT working scored by observers on a 4-point scale (very poor – very good) | Team (attendance, leadership; chairing, teamworking & culture, personal development & training) Infrastructure for meetings (meeting venue, technology & equipment) Meeting organization and logistics (preparation prior to meetings, organization/ administration during meetings) Clinical decision making (patient centered care, treatment plans) Characteristic of effective MDT-working (teamwork & culture) | Taylor C. et al., 2012 [84] |