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Observational Study
. 2021 Nov;28(12):7577-7588.
doi: 10.1245/s10434-021-09989-7. Epub 2021 May 11.

Development and Validation of a Short Version of the Metric for the Observation of Decision-Making in Multidisciplinary Tumor Boards: MODe-Lite

B W Lamb  1   2 , S Miah  3 , T A Skolarus  4   5 , G D Stewart  1   6 , J S A Green  7   8 , N Sevdalis  8 , T Soukup  9
Affiliations
Observational Study

Development and Validation of a Short Version of the Metric for the Observation of Decision-Making in Multidisciplinary Tumor Boards: MODe-Lite

B W Lamb et al. Ann Surg Oncol. 2021 Nov.

Abstract

Background: Evidence-based tools are necessary for scientifically improving the way MTBs work. Such tools are available but can be difficult to use. This study aimed to develop a robust observational assessment tool for use on cancer multidisciplinary tumor boards (MTBs) by health care professionals in everyday practice.

Methods: A retrospective cross-sectional observational study was conducted in the United Kingdom from September 2015 to July 2016. Three tumor boards from three teaching hospitals were recruited, with 44 members overall. Six weekly meetings involving 146 consecutive cases were video-recorded and scored using the validated MODe tool. Data were subjected to reliability and validity analysis in the current study to develop a shorter version of the MODe.

Results: Phase 1, a reduction of the original items in the MODe, was achieved through two focus group meetings with expert assessors based on previous research. The 12 original items were reduced to 6 domains, receiving full agreement by the assessors. In phase 2, the six domains were subjected to item reliability, convergent validation, and internal consistency testing against the MODe-Lite global score, the MODe global score, and the items of the MODe. Significant positive correlations were evident across all domains (p < 0.01), indicating good reliability and validity. In phase 3, feasibility and high inter-assessor reliability were achieved by two clinical assessors. Six domains measuring clinical input, holistic input, clinical collaboration, pathology, radiology, and management plan were integrated into MODe-Lite.

Conclusions: As an evidence-based tool for health care professionals in everyday practice, MODe-Lite gives cancer MTBs insight into the way they work and facilitates improvements in practice.

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Conflict of interest statement

GDS is supported by The Mark Foundation for Cancer Research, the Cancer Research UK Cambridge Centre [C9685/A25177] and NIHR Cambridge Biomedical Research Centre (BRC-1215-20014). BWL and TS have previously received funding from Cancer Alliances, NHS England, and Health Education England for training cancer MDTs in assessment and quality improvement methods in the United Kingdom. TS also received fees from Roche Diagnostics for research services in relation to innovations for cancer MDTs in the United States of America. N. Sevdalis is the Director of London Safety & Training Solutions, Ltd, which provides team-working, patient safety, and improvement skills training and advice on a consultancy basis to hospitals and training programs in the UK and internationally. J. S. A. Green is a Director of Green Cross Medical Ltd that developed MDT FIT for use by National Health Service Cancer Teams in the UK. G. D. Stewart has received educational grants from Pfizer, AstraZeneca, and Intuitive Surgical; consultancy fees from Merck, Pfizer, EUSA Pharma, and CMR Surgical; travel expenses from Pfizer; and speaker fees from Pfizer. T. A. Skolarus receives authorship royalties from UpToDate. S. Miah has no competing interests to declare.

Figures

Fig. 1.
Fig. 1.
Copy of the MODe-LITE tool. MODe-LITE Copyright 2021 © Soukup Lamb under CC-BY-NC-ND
Fig. 2.
Fig. 2.
Schematic representing the phases of the multidisciplinary team working with application of quality-improvement tools. Reprinted with permission from
See this image and copyright information in PMC

Comment in

References

    1. Lamb BW, Brown KF, Nagpal K, Vincent C, Green JS, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18:2116–2125. doi: 10.1245/s10434-011-1675-6. - DOI - PubMed
    1. Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13,722 women. BMJ. 2012;344:e2718. doi: 10.1136/bmj.e2718. - DOI - PMC - PubMed
    1. Taylor C, Ramirez AJ. Multidisciplinary team members’ views about MDT working: results from a survey commissioned by the national cancer action team. London: NHS National Cancer Action Team; 2019.
    1. Soukup T, Lamb BW, Sarkar S, Arora S, Shah S, Darzi A, et al. Predictors of treatment decisions in multidisciplinary oncology meetings: a quantitative observational study. Ann Surg Oncol. 2016;23:4410–4417. doi: 10.1245/s10434-016-5347-4. - DOI - PubMed
    1. Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49. doi: 10.2147/JMDH.S117945. - DOI - PMC - PubMed

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