Struggling to show tumor board relevance: Video recordings...

J Urol. 2014 Mar 11. pii: S0022-5347(14)02914-0. doi: 10.1016/j.juro.2014.03.002. [Epub ahead of print]

Validation of team performance assessment for multidisciplinary tumor boards.

Jalil R1, Akhter W2, Lamb BW3, Taylor C4, Harris J4, Green JS5, Sevdalis N6.

Author information

• 1Department of Surgery and Cancer, Imperial College London, UK; Whipps Cross University Hospital, Barts Health NHS Trust, London, UK. Electronic address: r.jalil@imperial.ac.uk.
• 2Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.
• 3Department of Surgery and Cancer, Imperial College London, UK; Department of Urology, Lister Hospital, London, UK.
• 4King's College London, UK.
• 5Whipps Cross University Hospital, Barts Health NHS Trust, London, UK; Department of Health and Social Care, London Southbank University, London, UK.
• 6Department of Surgery and Cancer, Imperial College London, UK.

Abstract

OBJECTIVE:

To construct validate the 'Multidisciplinary Tumor Board Metric for the Observation of Decision-Making' instrument (MTB-MODe), to evaluate assessors' learning curves, and to evaluate its feasibility and inter-rater reliability for assessing the decision-making process of video-recorded MTB meetings.

BACKGROUND:

MTBs are becoming the standard practice in managing cancer patients internationally - however, there are no agreed standards to assess the efficacy of such teams. The MTB-MODe tool assesses the process of MTB decision-making via standardized observation (1-5 anchored scales) of the quality of information presented at the MTB and MTB-members' contribution to case review.

METHODS:

A total of 683 MTB case-discussions were assessed using MTB-MODe in a multi-phased study: 332 cases (9 urology MTBs) by 1 urologist in vivo; 224 cases (6 urology MTBs) by 2 urologists in vivo. The instrument was refined and subsequently used to rate 127 cases of eight video-recorded MTBs of five different tumor types.

RESULTS:

Good inter-rater reliability was achieved in vivo and transferred to the video-recorded MTB meetings that remained consistent (Intra-Class Correlations≥0.70). MTB-MODe scores were higher in cases that resulted in a decision (mean=2.54, SD=0.47) than cases where no decision was reached (mean=2.02, SD=0.65) (P≤0.001).

CONCLUSIONS:

A standardized method to assess the quality of MTB working can enhance the quality of cancer care and the ability of MTBs to evaluate their own performance enables promotion of good practice. Video recordings offer a feasible and reliable method of assessing MTB working.