Journal of Multidisciplinary Healthcare (Jun 2021)
Decision-Making in Multidisciplinary Tumor Boards in Breast Cancer Care – An Observational Study
Abstract
Barbara Schellenberger,1,2 Annika Diekmann,1,2 Christian Heuser,1,2 Nikoloz Gambashidze,3 Nicole Ernstmann,1– 3 Lena Ansmann4 1Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany; 2Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Bonn, Germany; 3Institute for Patient Safety, University Hospital Bonn, Bonn, Germany; 4Division for Organizational Health Services Research, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyCorrespondence: Barbara Schellenberger Venusberg Campus 1, Bonn, 53127, GermanyTel +49 228 287 13797Email [email protected]: Healthcare providers decide on recommendations for further treatment of patients with cancer in multidisciplinary tumor boards (MTBs). As such, communicative processes during MTBs are assumed to influence decision-making and, thereby, treatment planning. The aim of this exploratory study is to gain insights into decision-making during MTBs.Methods: Case discussions from MTBs in breast cancer centers in North Rhine-Westphalia, Germany, were observed and audiotaped. The transcripts of the audio recordings were analyzed by procedures of conversation analysis.Results: Based on 38 case discussions from 15 MTBs in four breast cancer centers, an action scheme for decision-making in MTBs in breast cancer care was developed. In addition, the conversational practices used by the participants during interactions were analyzed.Conclusion: Analysis indicated that conventions in MTBs were observed during individual phases of decision-making but not for the entire process. Although exchanging multidisciplinary knowledge is an essential aspect of MTBs, this exchange does not always seem to occur in practice. The extent to which recommendations are derived from consensus during MTBs remains unclear. Thus, the study suggests developing standards for communication during MTBs to optimize decision-making and, thus, the quality of recommendation.Keywords: breast cancer, communication, multidisciplinary treatment team, multidisciplinary tumor conferences, oncology
