Cancer Multidisciplinary Team Meetings: Evidence, Challenges, and the Role of Clinical Decision Support Technology

Table 1

Summary of empirical evidence on the effectiveness of cancer MDT meetings.

Outcomes assessed	Study	𝐸^∗	Total cases	Cancer type	Difference in MDT meeting arm and control arm with respect to the outcome
Survival	[7]	2b	88	Lung	NSD
	[8]	3b	67	Glioma	NSD (18.7 versus 11.9 months, 𝑃=0.11)
	[9]	4	240	Lung	NSD
	[10]	4	144	Oesophageal	5 years (52% versus 10%, 𝑃<0.001)
	[11]	4	243	Lung	Median (6.6 months versus 3.2 months)^§
	[12]	4	533	Ovarian	In favour of MDT group^§
	[13]	4	16035	All cancers	5 years (71% versus 63%, 𝑃<0.001)
	[14]	4	—	Lung	1 year (23.5% versus 18.3%)^§
Quality of life	[7]	2b	88	Lung	NSD
Patient experience	[7]	2b	88	Lung	Improved in MDT group, 𝑃=0.01
	[15]	4	269	Breast	Improved in MDT group, 𝑃<0.001
Rate of intervention	[11]	4	243	Lung	Patients receiving chemo (23% versus 7%)^§
	[16]	4	112	Lung	30% ↑ in resection in favour of MDT
	[8]	3b	67	Glioma	Patients having chemo (55% versus 17%)^§
	[9]	4	240	Lung	↑ in resection (23.4 % versus 12.2%)^§
	[17]	3b	2935	Colorectal	↑ in trial recruitment (10.3 versus 5.1%)^§
Time to intervention	[15]	4	269	Breast	Time to treatment (29.6 versus 42.2 days)^§
	[16]	4	112	Lung	NSD
	[8]	3b	67	Glioma	NSD
Staging accuracy	[18]	3b	118	Upper GI	MDT improved staging accuracy^§
Costs per patients	[19]	4	208	Melanoma	MDT saved $1600 per patient
Decision quality as prediction of accuracy	[20]	4	50	Lung	NSD, Team discussion did not improve the quality of decision making overall.
Psychological morbidity of team members	[21]	5	72	Breast	lower prevalence of psychiatric morbidity (15.7% versus 26.6% 𝑃<0.005)

𝐸^∗: levels of evidence as defined by Oxford Centre for Evidence-Based Medicine (1a: systematic review of RCTs, 1b: individual RCT (with narrow Confidence Interval), 1c: all or none, 2a: systematic review of cohort studies, 2b: individual cohort study (including low quality RCT), 2c: “Outcomes” Research, 3a: systematic review of case-control studies, 3b: individual Case-Control Study, 4: case-series (and poor quality cohort and case-control studies), 5: expert opinion without explicit critical appraisal, or based on physiology, bench research or “first principles”), NSD: no significant difference found in both groups, ^§statistically significant differences, and chemo: chemotherapy.