zdmeЗдоровье мегаполисаCity Healthcare2713-2617ГБУ «НИИОЗММ ДЗМ»10.47619/2713-2617.zm.2020.v1i1;108-111zdme-236Research ArticleКРАТКИЕ НАУЧНЫЕ СООБЩЕНИЯBRIEF REPORTSМультидисциплинарное обсуждение в онкологииMultidisciplinary team discussion in onkologyhttps://orcid.org/0000-0001-7457-3889КалининА. Е.KalininA. E.

Калинин Алексей Евгеньевич, к. м. н., старший научный сотрудник онкологического отделения хирургических методов лечения № 6

115478, Москва, Каширское ш., 24

Alexey E. Kalinin, PhD

23, Kashirskoe highway, 115478, Moscow

main2001@inbox.ruhttps://orcid.org/0000-0002-6151-5660ГущинВ. В.GushchinV. V.

Гущин Вадим Викторович, Mercy Medical Center, The Institute for Cancer Care at Mercy

Балтимор, США

Vadim V. Guschin

Baltimor, USA

Национальный медицинский исследовательский центр онкологии имени Н. Н. Блохина» Министерства здравоохранения Российской ФедерацииРоссияN.N. Blokhin Russian Cancer Research CenterRussian FederationInstitute for Cancer Care at MercyСоединённые Штаты АмерикиMercy Medical Center, The Institute for Cancer Care at MercyUnited States20200303202011108111Copyright © Калинин А.Е., Гущин В.В., 20202020Калинин А.Е., Гущин В.В.Kalinin A.E., Gushchin V.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.city-healthcare.com/jour/article/view/236

Для лечения сложных пациентов в условиях постоянно обновляющихся медицинских знаний был предложен важный организационный инструмент − Мультидисциплинарное обсуждение (МДО). МДО может улучшать качество диагностики, лечения пациентов, а также предоставить дополнительную возможность для профессионального сотрудничества в медицинском коллективе. За последние несколько лет МДО пациентов стали стандартной практикой в онкологии и основой для принятия клинических решений. Обсуждения проводятся при участии онкологов всех специальностей, и планирование лечения по возможности основывается на принципах доказательной медицины. В статье мы обсуждаем аргументы за и против, цели, варианты и общие правила эффективного МДО.

The multidisciplinary team (MDT) conference has evolved as an essential instrument in the optimal management of a complex patient in the era of ever-changing medical knowledge. MDT discussions may improve the quality of diagnosis and treatment as well as provide an additional formal opportunity for collaboration among colleagues. MDT conference has become the standard of care and decision making tool in oncology. Such meetings include medical staff from all oncology-related services, and the decision is encouraged to be supported by the principles of evidence-based medicine. This paper provides an overview of the goals, pitfalls, and general recommendations for holding a productive MDT discussion.

мультидисциплинарное обсуждениеонкологическая помощьконсилиумcancermultidisciplinary team meetingpatient assessmentReferencesWalsh, J. et al. What are the current barriers to effective cancer care coordination? A qualitative study. BMC Health Serv. Res. 10, (2010).Walsh, J. et al. What are the current barriers to effective cancer care coordination? A qualitative study. BMC Health Serv. Res. 10, (2010).Borras, J. M. et al. Policy statement on multidisciplinary cancer care. Eur. J. Cancer 50, 475–480 (2014).Borras, J. M. et al. Policy statement on multidisciplinary cancer care. Eur. J. Cancer 50, 475–480 (2014).Prades, J., Remue, E., van Hoof, E. & Borras, J. M. 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. Health Policy 119, 464–474 (2015).Prades, J., Remue, E., van Hoof, E. & Borras, J. M. 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. Health Policy 119, 464–474 (2015).Ajani, J. A. et al. Continue NCCN Guidelines Panel Disclosures NCCN Guidelines Version 2.2020 Gastric Cancer. (2020).Ajani, J. A. et al. Continue NCCN Guidelines Panel Disclosures NCCN Guidelines Version 2.2020 Gastric Cancer. (2020).Rosell, L., Alexandersson, N., Hagberg, O. & Nilbert, M. Benefits, barriers and opinions on multidisciplinary team meetings: A survey in Swedish cancer care. BMC Health Serv. Res. 18, 1–10 (2018).Rosell, L., Alexandersson, N., Hagberg, O. & Nilbert, M. Benefits, barriers and opinions on multidisciplinary team meetings: A survey in Swedish cancer care. BMC Health Serv. Res. 18, 1–10 (2018).Fallowfield, L., Langridge, C. & Jenkins, V. Communication skills training for breast cancer teams talking about trials. Breast 23, 193–197 (2014).Fallowfield, L., Langridge, C. & Jenkins, V. Communication skills training for breast cancer teams talking about trials. Breast 23, 193–197 (2014).Pillay, B. et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature. Cancer Treat. Rev. 42, 56–72 (2016).Pillay, B. et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature. Cancer Treat. Rev. 42, 56–72 (2016).Basta, Y. L., Bolle, S., Fockens, P. & Tytgat, K. M. A. J. The Value of Multidisciplinary Team Meetings for Patients with Gastrointestinal Malignancies: A Systematic Review. Ann. Surg. Oncol. 24, 2669–2678 (2017).Basta, Y. L., Bolle, S., Fockens, P. & Tytgat, K. M. A. J. The Value of Multidisciplinary Team Meetings for Patients with Gastrointestinal Malignancies: A Systematic Review. Ann. Surg. Oncol. 24, 2669–2678 (2017).Coory, M., Gkolia, P., Yang, I. A., Bowman, R. V. & Fong, K. M. Systematic review of multidisciplinary teams in the management of lung cancer. Lung Cancer 60, 14–21 (2008).Coory, M., Gkolia, P., Yang, I. A., Bowman, R. V. & Fong, K. M. Systematic review of multidisciplinary teams in the management of lung cancer. Lung Cancer 60, 14–21 (2008).El Saghir, N. S. et al. Global Practice and Efficiency of Multidisciplinary Tumor Boards: Results of an American Society of Clinical Oncology International Survey. J. Glob. Oncol. 1, 57–64 (2015).El Saghir, N. S. et al. Global Practice and Efficiency of Multidisciplinary Tumor Boards: Results of an American Society of Clinical Oncology International Survey. J. Glob. Oncol. 1, 57–64 (2015).Lamb, B. W. et al. Quality of care management decisions by multidisciplinary cancer teams: A systematic review. Annals of Surgical Oncology 18, 2116–2125 (2011).Lamb, B. W. et al. Quality of care management decisions by multidisciplinary cancer teams: A systematic review. Annals of Surgical Oncology 18, 2116–2125 (2011).Lamb, B. W. et al. Teamwork and team decisionmaking at multidisciplinary cancer conferences: Barriers, facilitators, and opportunities for improvement. World J. Surg. 35, 1970–1976 (2011).Lamb, B. W. et al. Teamwork and team decisionmaking at multidisciplinary cancer conferences: Barriers, facilitators, and opportunities for improvement. World J. Surg. 35, 1970–1976 (2011).Mannion R., Thompson C. Systematic biases in group decision-making: implications for patient safety Intern J Quality in Health Care, 2014, Vol. 26, Iss. 6, p. 606–612Mannion R., Thompson C. Systematic biases in group decision-making: implications for patient safety Intern J Quality in Health Care, 2014, Vol. 26, Iss. 6, p. 606–612Croskerry P. Cognitive forcing strategies in clinical decision making, Ann Emerg Med, 2003, vol. 41 (pg. 110-22)Croskerry P. Cognitive forcing strategies in clinical decision making, Ann Emerg Med, 2003, vol. 41 (pg. 110-22)Croskerry P. Achieving quality in clinical decision making: cognitive strategies and detection of bias, Acad Emerg Med, 2002, vol. 9 (pg. 1184-204)Croskerry P. Achieving quality in clinical decision making: cognitive strategies and detection of bias, Acad Emerg Med, 2002, vol. 9 (pg. 1184-204)

The authors declare that there are no conflicts of interest present.