Using an Adapted Tumor Board Evaluation Tool for Quality Assessment of a Thoracic Multidisciplinary Cancer Conference: A Pilot Study.

PURPOSE: Multidisciplinary cancer conferences (MCCs) are crucial for the management of complex oncology patients. Tools to evaluate MCC performance are needed. The aim of this pilot study was to assess the applicability of an existing validated performance assessment tool to evaluate the quality of thoracic MCCs (T-MCCs). METHODS: Data were collected from weekly T-MCCs over a 5-week period using the MCC Performance Assessment Tool and a self-assessment survey. Audio recordings were used to supplement observation notes. Case presentation, discussion duration, decision making contribution, recommendations, and consensus were captured. Quality of information and contribution were rated on a 1-5 scale. The data were analyzed using descriptive statistics to calculate means and composite scores representing overall MCC performance. RESULTS: A total of 44 cases were observed at the T-MCC with the mean presentation and discussion time of 6 minutes and 22 seconds. Quality of case history, radiologic and pathological information, and reason for case discussion were rated above average (>3), whereas inclusion of comorbidities and patient views were rated below average. Surgical oncologists had a higher discussion contribution compared with medical and radiation oncologists (3.6 v 2.9 and 2.4, respectively). The overall mean composite score was 55.9 (deemed average) with no cases categorized as poor or excellent. Radiologists and pathologists had mean preparation times of 81.7 and 144.0 minutes, respectively. CONCLUSION: This study demonstrated the applicability of a previously validated tool to assess the quality of a T-MCC at an academic comprehensive cancer center. The tool was found to be useful in identifying elements of the T-MCC process that needed improvement.

Impact of a Thoracic Multidisciplinary Conference on Lung Cancer Outcomes.

BACKGROUND: With the complexity of cancer treatment rising, the role of multidisciplinary conferences (MDCs) in making diagnostic and treatment decisions has become critical. This study evaluated the impact of a thoracic MDC (T-MDC) on lung cancer care quality and survival. METHODS: Lung cancer cases over 7 years were identified from the Roswell Park cancer registry system. The survival rates and treatment plans of 300 patients presented at the MDC were compared with 300 matched patients. The National Comprehensive Cancer Network (NCCN) guidelines were used to define the standard of care. The compliance of care plans with NCCN guidelines was summarized using counts and percentages, with comparisons made using the Fisher exact test. Survival outcomes were summarized using Kaplan-Meier methods. RESULTS: There was improvement in median overall survival (36.9 vs 19.3 months; P < .001) and cancer-specific survival (48 vs 28.1 months; P < .001) for lung cancer patients discussed at the T-MDC compared with controls. These differences were statistically significant in patients with stages III/IV disease but not in patients with stages I/II disease. The NCCN guidelines compliance rate of treatment plans improved from 80% to 94% (P < .001) after MDC discussion. MDC recommendations resulted in treatment plan changes in 123 of 300 patients (41%). CONCLUSIONS: Our results suggest that lung cancer patients have a survival benefit from MDC discussion compared with controls. Patients with advanced disease (stages III and IV) benefited the most. Further research is necessary to understand the precise mechanisms that drive these results.