title: Decision-making in Colorectal Cancer Tumor Board meetings: results of a prospective observational assessment.
abstract: BACKGROUND
  The management of colorectal cancer increasingly involves multidisciplinary tumor boards. In cases where these occur, the quality can be variable. Despite this, there are no uniform measures to evaluate them. The aim of this study was to evaluate the performance of colorectal cancer tumor boards, via real-time prospective observation.
  
  
  METHODS
  An observational tool, termed Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess decision-making in 267 cases. The presentation of case history, radiological and pathological information, as well as contributions to decision making of the various team members were analyzed using descriptive statistics and t-tests. Interobserver agreement was assessed using intraclasscorrelation coefficients.
  
  
  RESULTS
  Tumor board meetings lasted 76 min, were attended by approximately 16 specialists each, and reviewed an average of 24 cancer cases (3 min per case review). Regarding the quality of presented information to the team, case history information was rated the highest (mean 4.57), followed by radiological information (mean 4.22) and pathological information (mean 3.81). Regarding each team-member's contribution to discussion, surgeons were scored the highest (mean 4.81), followed by radiologists (mean 4.41) and meeting chairs (mean 4.13)--all team members except the board coordinators were scored highly. Overall scoring reliability was good (0.79).
  
  
  CONCLUSIONS
  The cMDT-MODe instrument can be reliably used to prospectively assess decision making in the multidisciplinary management of colorectal patients. By systematically quantifying the quality of a colorectal cancer tumor board, we can identify areas for improving practice so as to optimize decision making for cancer care.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, W2 1PG, UK, sujay.shah@imperial.ac.uk.
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Arora
authors.forename: G
authors.initials: G
authors.lastname: Atkin
authors.forename: R
authors.initials: R
authors.lastname: Glynne-Jones
authors.forename: P
authors.initials: P
authors.lastname: Mathur
authors.forename: A
authors.initials: A
authors.lastname: Darzi
authors.forename: N
authors.initials: N
authors.lastname: Sevdalis
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies; D011785:Quality Assurance, Health Care