Evidence map›Paper›PMID 35137091›Full record

Observational studyInternational journal for quality in health care : journal of the International Society for Quality in Health Care2022

Using guideline-based clinical decision support in oncological multidisciplinary team meetings: A prospective, multicenter concordance study.

Kees C W J Ebben, Mathijs P Hendriks, Lieke Markus, Milan Kos, Ignace H J T De Hingh, Jorg R Oddens, Joost Rothbarth, Hans De Wilt, Luc J A Strobbe, Maud Bessems and 3 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
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

13 authors.

Kees C W J EbbenDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.ORCID 0000-0003-1069-2357
Mathijs P HendriksDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.ORCID 0000-0001-6687-5393
Lieke MarkusDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.
Milan KosDepartment of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam 1105AZ, Noord-Holland, The Netherlands.
Ignace H J T De HinghDepartment of Surgical Oncology, Catharina Hospital, Michelangelolaan 2, Eindhoven 5623EJ, The Netherlands.
Jorg R OddensDepartment of Urology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam 1105AZ, Noord-Holland, The Netherlands.
Joost RothbarthDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, Rotterdam 3015GD, The Netherlands.
Hans De WiltDepartment of Surgical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen 6525GA, The Netherlands.ORCID 0000-0001-6773-9668
Luc J A StrobbeDepartment of Surgical Oncology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, Nijmegen 6532SZ, The Netherlands.
Maud BessemsDepartment of Surgical Oncology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 's-Hertogenbosch 5223 GZ, The Netherlands.
Carsten T MellemaDepartment of Urology, Spaarne Hospital, Boerhavelaan 22, Haarlem 2035RC, The Netherlands.
Sabine SieslingDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.ORCID 0000-0002-0273-824X
Xander A A M VerbeekDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultidisciplinary team meetings formulate guideline-based individual treatment plans based on patient and disease characteristics and motivate reasons for deviation. Clinical decision trees could support multidisciplinary teams to adhere more accurately to guidelines. Every clinical decision tree is tailored to a specific decision moment in a care pathway and is composed of patient and disease characteristics leading to a guideline recommendation.

objectiveThis study investigated (1) the concordance between multidisciplinary team and clinical decision tree recommendations and (2) the completeness of patient and disease characteristics available during multidisciplinary team meetings to apply clinical decision trees such that it results in a guideline recommendation.

methodsThis prospective, multicenter, observational concordance study evaluated 17 selected clinical decision trees, based on the prevailing Dutch guidelines for breast, colorectal and prostate cancers. In cases with sufficient data, concordance between multidisciplinary team and clinical decision tree recommendations was classified as concordant, conditional concordant (multidisciplinary team specified a prerequisite for the recommendation) and non-concordant.

resultsFifty-nine multidisciplinary team meetings were attended in 8 different hospitals, and 355 cases were included. For 296 cases (83.4%), all patient data were available for providing an unconditional clinical decision tree recommendation. In 59 cases (16.6%), insufficient data were available resulting in provisional clinical decision tree recommendations. From the 296 successfully generated clinical decision tree recommendations, the multidisciplinary team recommendations were concordant in 249 (84.1%) cases, conditional concordant in 24 (8.1%) cases and non-concordant in 23 (7.8%) cases of which in 7 (2.4%) cases the reason for deviation from the clinical decision tree generated guideline recommendation was not motivated.

conclusionThe observed concordance of recommendations between multidisciplinary teams and clinical decision trees and data completeness during multidisciplinary team meetings in this study indicate a potential role for implementation of clinical decision trees to support multidisciplinary team decision-making.

Indexed as

Decision Support Systems, ClinicalHumansMaleMedical OncologyPatient Care PlanningPatient Care TeamProspective Studiesalgorithmsclinical decision support systemclinical decision treesclinical practice guidelinesmultidisciplinary team meetingoncology

Identifiers

PMID35137091
PMCPMC8934031

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.