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Is it worth reorganising cancer services on the basis of multidisciplinary teams (MDTs)? A systematic review of the objectives and organisation of MDTs and their impact on patient outcomes

机译:在多学科团队(MDT)的基础上重组癌症服务是否值得?对MDT的目标和组织及其对患者预后的影响进行系统的审查

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摘要

Multidisciplinary teams (MDTs) are considered the gold standard of cancer care in many healthcare systems, but a clear definition of their format, scope of practice and operational criteria is still lacking. The aims of this review were to assess the impact of MDTs on patient outcomes in cancer care and identify their objectives, organisation and ability to engage patients in their care. We conducted a systematic review of the literature in the Medline database. Fifty-one peer-reviewed papers were selected from November 2005 to June 2012. MDTs resulted in better clinical and process outcomes for cancer patients, with evidence of improved survival among colorectal, head and neck, breast, oesophageal and lung cancer patients in the study period. Also, it was observed that MDTs have been associated with changes in clinical diagnostic and treatment decision-making with respect to urological, pancreatic, gastro-oesophageal, breast, melanoma, bladder, colorectal, prostate, head and neck and gynaecological cancer. Evidence is consistent in showing positive consequences for patients' management in multiple dimensions, which should encourage the development of structured multidisciplinary care, minimum standards and exchange of best practices.
机译:在许多医疗保健系统中,多学科团队(MDT)被认为是癌症护理的金标准,但是仍然缺乏对其格式,业务范围和操作标准的明确定义。这项审查的目的是评估MDT对癌症护理中患者预后的影响,并确定其目标,组织和使患者参与其护理的能力。我们对Medline数据库中的文献进行了系统的回顾。从2005年11月至2012年6月,选择了51篇经同行评审的论文。MDTs为癌症患者带来了更好的临床和过程结果,并且有证据表明该研究的结直肠癌,头颈癌,乳腺癌,食道癌和肺癌患者的生存期得到了改善期。此外,还观察到MDTs与泌尿科,胰腺癌,胃食管癌,乳腺癌,黑素瘤,膀胱癌,结直肠癌,前列腺癌,头颈癌和妇科癌的临床诊断和治疗决策改变有关。证据是一致的,它从多个方面显示了对患者管理的积极影响,应鼓励发展结构化的多学科护理,最低标准和最佳做法的交流。

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