Tools and Strategies to Integrate Multi-Domain Information for Personalized Decision-Making in Oncological Care Pathways: A Scoping Review

Abstract

Thanee M Uittenhout,1 Jesse Jansen,1 Kon-Siong Jie,2 Lieke Welling,3 Barbara L van Leeuwen,4 Leti van Bodegom-Vos,5 Anne M Stiggelbout,5,6 Trudy van der Weijden,1 IPTO Consortium: the scientific members of the IPTO ConsortiumA. Koch, F.M. van Nuenen, H. van der Wal-Huisman, L.L. van Baalen, M.J. Nogarede, S. Festen, V.C. Hanewinkel On behalf of the IPTO Consortium1Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences (FHML) Maastricht University, Maastricht, the Netherlands; 2Department of Internal Medicine, Zuyderland Medical Center, Sittard, the Netherlands; 3Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands; 4Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 5Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; 6Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the NetherlandsCorrespondence: Thanee M Uittenhout, Email [email protected]: There is a growing interest in personalized decision-making in oncology. According to the Integrated Oncological Decision-Making Model (IODM), decisions should be based on information from three domains: (1) medical technical information, (2) patients’ general health status and (3) patients’ preferences and goals. Little is known about what kind of tool/strategy is used to collect the information, by whom this is collected (nurse, clinician) when this is collected (moment in the care pathway), and how this information should be collected and integrated within decision-making in oncological care pathways, and what its impact is.Methods: We searched PUBMED, Embase and Web of Science in October 2023 for studies looking at tools to collect and integrate information from the three domains of the IODM. We extracted data on the content and implementation of these tools, and on decision and patient outcomes.Results: The search yielded 2576 publications, of which only seven studies described collection of information from all three domains (inclusion criteria). In the seven included studies, information on the three domains was collected through dialogue, questionnaires, and assessments (what) by a nurse (2 out of 7 studies) or by other members of the Multi-Disciplinary Team (by whom) (5 out of 7 studies). Members of the Multi-Disciplinary Team subsequently integrated the information (5 out 7 studies) during their meeting (when), with patients and family attending this meeting in 2 studies (how). In terms of decision outcomes, 5 out of 7 studies compared the treatment recommendations before and after implementation of the tools, showing a modification of the treatment plan in 3% to 53% of cases. The limited data on patient outcomes suggest positive effects on well-being and fewer complications (3 out of 7 studies).Conclusion: The seven studies identified that integrated information from the three IODM domains into treatment decision-making lacked comprehensive information regarding the strategies, process, timing and individuals involved in implementing the tools. Nevertheless, the few studies that looked at patient outcomes showed promising findings.Keywords: person centred care, patient centred care, patient preferences, treatment decision-making, multi-disciplinary team, oncology

Keywords

• person centred care ∙ patient centred care ∙ patient preferences ∙ treatment decision-making ∙ multi-disciplinary team ∙ oncology