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. 2020 Jan 31;20:73. doi: 10.1186/s12913-020-4930-3

Table 3.

Outcomes and outputs in the reviews retrieved. Main findings

Outcome / Output Author / Year N. of studies Results / Findings
Care coordination Prades et al., 2015 [31] 22 Format, data management and professional roles of TBs impacted positively on care coordination for professionals and patients.
Diagnosis (Patient assessment, diagnosis, staging) Lamb et al., 2011 [30] 3 Improvement in diagnostic accuracy was reported.
Prades et al., 2015 [31] 8 Multidisciplinary setting improved diagnosis and staging accuracy.
Pillay et al., 2016 [32] 15 Diagnostic reports changed after the meeting in 4–35% of patients discussed.
6 The impact of the TB on assessment and diagnosis was significant (higher accuracy in staging).
Basta et al., 2017 [34] 1 No changes in diagnosis or stage were reported after validation by pathology or after follow-up.
4 TBs changed the diagnoses formulated by referring physicians in 18.4–26.9% of cases.
2 TBs formulated an accurate diagnosis in 89 and 93.5% of evaluated cases.
2 Discussion during the TB influenced staging. After introduction of the TB, more patients underwent computed tomography (CT) before operation and patients discussed more often received a complete staging evaluation.
Treatment (Practice patterns, clinical practice, patient management, Implementation of treatment changes) Coory et al., 2008 [33] 1 A not statistically significant larger percentage of patients discussed in TB (43%) received radical treatment than the control group (33%).
1 A statistically significant increase in the percentage of patients older than 70 years receiving radical radiotherapy (from 3% in 1995 to 12% in 2000; p = 0.004) was reported. The percentage receiving palliative radiotherapy decreased (from 65 to 55%).
1 A statistically significant increase in the percentage of patients receiving chemotherapy (from 7% in 1997 to 23% in 2001; p < 0.001) was reported. The percentage of patients receiving palliative care decreased (from 58 to 44%; p = 0.0045) and the percentage of patients being formally staged increased (from 70 to 81%; p = 0.035).
3 Surgical resection rate was higher in MD groups.
Lamb et al., 2011 [30] 6 Changes in care management decisions were reported in 2–52% of cases.
1 TBs improved adherence to clinical guidelines.
1 Likelihood of patients being offered chemotherapy increased (from 7 to 23%)
6 Care management decisions by TBs were not implemented in 1–16% of cases due to contradictory patient choice or because of comorbidities.
Prades et al., 2015 [31] 21 TBs ensured more appropriate treatment through preoperative review of imaging and pathology results; multidisciplinary approach guaranteed the most up-to-date treatment, and set up a structured follow-up care plan.
Pillay et al., 2016 [32] 25 Changes in patient management/clinical practice were measured. Three studies reported minimal change in clinical management (less than 9% of cases), four studies indicated that the percentage of patients who underwent changes in treatment plans ranged from 19 to 34.5%. Other studies reported that changes in patient management plan following a TB occurred in 4.5–52% of cases.
13 Patients who were discussed were more likely to receive neoadjuvant or adjuvant treatment. Greater adherence to National Comprehensive Cancer Network (NCCN) guidelines was found in two studies.
Basta et al., 2017 [34] 9 Treatment plan formulated by the referring physician was altered in 23.0–41.7% of evaluated cases.
5 TB decisions on treatment plan were implemented in 90–100% of evaluated cases. The reasons for not following TB advice were comorbidity (45%) and patient preferences (35%), followed by new clinical information (10%), different opinion of the treating physician (5%), and unknown (5%).
3 TBs increased adherence to guidelines. Treatment plan more often adhered to national guidelines: 98% versus 83%.
Quality of life Coory et al., 2008 [33] 1 No statistically significant difference between groups was found
Prades et al., 2015 [31] 6 Improvement of patients’ quality of life
Recurrence and metastasis after resection Pillay et al., 2016 [32] 2 TB discussion had little positive impact on local recurrence rates of rectal cancer and incidence of metastases and remaining pelvic tumour after resection.
Satisfaction (patient or clinician) Coory et al., 2008 [33] 1 TBs resulted in better satisfaction for organisation of investigations and personal experience of care.
Prades et al., 2015 [31] 5 TBs improved patient and clinician satisfaction as a consequence of team work communication and cooperation.
Survival Coory et al., 2008 [33] 2 Two studies reported statistically significant survival improvement. 1 study reported an improvement of 3.2 months in median survival of patients with inoperable NSCLC, the other an increase from 18.3 to 23.5% in 1-year survival of lung cancer patients older than 70.
3 Three studies did not show a statistically significant improvement.
Lamb et al., 2011 [30] 1 Patients being offered chemotherapy showed a significant increase in survival (from 3.2 to 6.6 months).
Prades et al., 2015 [31] 10 Improvements in survival were reported for colorectal, head and neck, breast, oesophageal, and lung cancer.
Pillay et al., 2016 [32] 4 TB discussion was not associated with overall survival. However, in one of these studies, rectal cancer patients discussed had improved post-operative mortality.
2 Significant association was shown between TB discussion and survival of patients.
Visits to general practitioners Coory et al., 2008 [33] 1 Significantly fewer visits were reported for the MD group than the control group.
Waiting times Coory et al., 2008 [33] 3 In one study the median time from presentation to first treatment was 3 weeks in the MD arm (7 weeks in the control arm) but there was no difference in the time from diagnosis to radical treatment. Another study reported a reduction in mean time from presentation to surgery of 15 days. In the last study, a reduction of days from diagnosis to treatment from 29.3 to 18.8 was reported.
Prades et al., 2015 [31] 10 TBs resulted in reduction of time from diagnosis to treatment, and achievement of early and appropriate referral patterns.
Pillay et al., 2016 [32] 2 In two studies patients discussed in TBs had fewer mean days from diagnosis to treatment.
1 One study found an opposite trend.
Other Prades et al., 2015 [31] 7 TBs promoted the establishment of a teaching environment for healthcare professionals and junior doctors.
9 A commitment to research and clinical trials was maintained.
1 The enrolment in the tumour registry increased.