Evidence map›Paper›PMID 32580714›Full record

ArticleBMC health services research2020

Use of the KT-MCC strategy to improve the quality of decision making for multidisciplinary cancer conferences: a pilot study.

Christine Fahim, Meghan M McConnell, Frances C Wright, Ranil R Sonnadara, Marko Simunovic

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Christine FahimDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. Christine.fahim@unityhealth.to.
Meghan M McConnellDepartment of Innovation in Medical Education, University of Ottawa, RGN 2156, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada.
Frances C WrightDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Ranil R SonnadaraDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Marko SimunovicDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
McMaster University · CAImpact · CAUniversity of Ottawa · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultidisciplinary Cancer Conferences (MCCs) are increasingly used to guide treatment decisions for patients with cancer, though numerous barriers to optimal MCC decision-making quality have been identified. We aimed to improve the quality of MCC decision making through the use of an implementation bundle titled the KT-MCC Strategy. The Strategy included use of discussion tools (standard case intake tool and a synoptic discussion tool), workshops, MCC team and chair training, and audit and feedback. Implementation strategies were selected using a theoretically-rooted and integrated KT approach, meaning members of the target population (MCC participants) assisted with the design and implementation of the intervention and strategies. We evaluated implementation quality of the KT-MCC Strategy and initial signals of impact on decision making quality.

methodsThis was a before-and-after study design among 4 MCC teams. Baseline data (before-phase) were collected for a period of 2 months to assess the quality of MCC decision making. Study teams selected the intervention strategies they wished to engage with. Post-intervention data (after-phase) were collected for 4 months. Implementation quality outcomes included reach, adherence/fidelity and adaptation. We also evaluated feasibility of data management. Decision making quality was evaluated on a per-case and per-round level using the MTB-MODe and MDT-OARS tools, respectively.

resultsThere were a total of 149 cases and 23 MCCs observed in the before phase and 260 cases and 35 MCCs observed in the after phase. Teams implemented 3/5 strategies; adherence to selected strategies varied by MCC team. The per-round quality of MCCs improved by 11% (41.0 to 47.3, p = < 0.0001). The quality of per-case decision-making did not improve significantly (32.3 to 32.6, p = 0.781).

conclusionWhile per round MCC decision making quality improved significantly, per-case decision-making quality did not. We posit that the limited improvements on decision making quality may be attributed to implementation quality gaps, including a lack of uptake of and adherence to theoretically-identified implementation strategies. Our findings highlight the importance of evaluating implementation quality and processes, iterative testing, and engagement of key gatekeepers in the implementation process.

Indexed as

Congresses as TopicDecision MakingPatient Care ManagementFocus GroupsHumansNeoplasmsPilot ProjectsTranslational Research, BiomedicalBehaviour change wheelCancerIntegrated knowledge translationKnowledge-to-action cycleMultidisciplinary Cancer conferenceMultidisciplinary decision makingTheoretical domains framework

Identifiers

PMID32580714
PMCPMC7313105
OpenAlexW3037814526

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.