title: Validation of team performance assessment of multidisciplinary tumor boards.
abstract: OBJECTIVE
  We construct validated the instrument to evaluate assessor learning curves and the feasibility and interrater reliability of MTB-MODe for assessing the decision making process using video recorded multidisciplinary tumor board meetings.
  
  
  METHODS
  Multidisciplinary tumor boards are becoming standard practice for managing cancer internationally but no standards have been agreed on to assess the efficacy of such teams. The MTB-MODe tool assesses the process of multidisciplinary tumor board decision making by standardized observation (1 to 5 anchored scales) of the quality of information presented at the multidisciplinary tumor board as well as board member contributions to the case review. We assessed 683 multidisciplinary tumor board case discussions using MTB-MODe in a multiphase study, including 332 cases (9 urology boards) by 1 urologist in vivo and 224 cases (6 urology boards) by 2 urologists in vivo. The instrument was refined and subsequently used to rate 127 video recorded case discussions (5 tumor types) by a total of 8 multidisciplinary tumor boards.
  
  
  RESULTS
  Good interrater reliability was achieved in vivo and at the video recorded multidisciplinary tumor board meetings (ICC ≥0.70). MTB-MODe scores were higher in cases that resulted in a decision than in cases in which no decision was made (mean ± SD 2.54 ± 0.47 vs 2.02 ± 0.65, p ≤0.001).
  
  
  CONCLUSIONS
  A standardized method to assess the quality of multidisciplinary tumor board discussions can enhance the quality of cancer care and the ability of the boards to self-evaluate performance, thus, promoting good practice. Video recordings offer a feasible, reliable method of assessing how multidisciplinary tumor boards work.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Whipps Cross University Hospital, Barts Health National Health Service Trust, London, United Kingdom. Electronic address: r.jalil@imperial.ac.uk.
authors.forename: Rozh
authors.initials: R
authors.lastname: Jalil
authors.affiliation: Whipps Cross University Hospital, Barts Health National Health Service Trust, London, United Kingdom.
authors.forename: Waseem
authors.initials: W
authors.lastname: Akhter
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Urology, Lister Hospital, London, United Kingdom.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Lamb
authors.affiliation: King's College London, London, United Kingdom.
authors.forename: Cath
authors.initials: C
authors.lastname: Taylor
authors.affiliation: King's College London, London, United Kingdom.
authors.forename: Jenny
authors.initials: J
authors.lastname: Harris
authors.affiliation: Whipps Cross University Hospital, Barts Health National Health Service Trust, London, United Kingdom; Department of Health and Social Care, London Southbank University, London, United Kingdom.
authors.forename: James S A
authors.initials: JS
authors.lastname: Green
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
mesh_terms: D003657:Decision Making; D005240:Feasibility Studies; D006801:Humans; D033183:Interdisciplinary Communication; D059032:Learning Curve; D009369:Neoplasms / Q000628:therapy; D015588:Observer Variation; D010348:Patient Care Team / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D014741:Video Recording
keywords: health care; interdisciplinary communication; neoplasms; quality assurance; urology; video recording