Management of confirmed breast cancer

Download the Paper

Description: Decision support for management of confirmed breast cancer by multidisciplinary teams

Publet Introduction:

The purpose of MATE is to support transparent evidence-based decision making in breast cancer management .The goal is to help breast clinicians make treatment decisions explicitly based on best available evidence. The clinical knowledge-base used by MATE is based on high quality national and international clinical practice guidelines such as NICE, SIGN, NCCNetc and systematic reviews e.g. EBCTCG overviews. The knowledge base is modular, scalable and regularly updated through an established review process. The MATE tool also makes use of the published medical calculators and algorithms such as TNM staging, MSKCC nomogram, Nottingham prognostic index, Van Nuys prognostic index and adjuvantOnline prediction tool. Importantly it also screen patients for ongoing clinical trials and prompts the clinician whenever the patient is found eligible. A version of MATE was used in a major audit study at the Royal Free Hospital in London. This reported promising results in terms of significant greater compliance with published clinical guidelines and identification of patients eligible for participation in clinical trials, reported in BMJ Open (2012).

It is essential to emphasise, however, that the role of CDS system like MATE is only to suggest optimal management strategy, laying out the medical logic and relevant supporting documentation and research relevant to each patient; the decision is of course the responsibility of the members of the MDT. Since such systems can compare all MDM decisions with recommendations in national guidelines they can also be used to carry out prospective audit.

MATE is no longer being maintained in this form; it is provided solely as a technical demonstration and may not be used for clinical purposes. Information about clinical strength versions of MATE and other applications, and advanced tools for developing and deploying such applications is available from Deontics Ltd.


  Information
Guideline objectives

To provide support for evidence-based decision making in breast cancer management and assist breast clinicians make treatment decisions based on best available evidence.  

Target setting Breast Cancer MDM (Tumor board)
Target users Breast Cancer multidisciplinary team
Overview

The purpose of MATE is to support transparent evidence-based decision making in breast cancer management .The goal is to help breast clinicians make treatment decisions explicitly based on best available evidence. The clinical knowledge-base used by MATE is based on high quality national and international clinical practice guidelines such as NICE, SIGN, NCCNetc and systematic reviews e.g. EBCTCG overviews.  A prospective audit study to compare decision making by the multidisciplinary team with recommendations for care by MATE has been carried out and data analysed for 1200 women with proven breast cancer with positive results (Patkar et al, BMJ Open (2012).

Provenance 1. A successful randomised trial of the application has been carried out
Management
  • Author: Vivek Patkar, Dionisio Acosta, Mo Keshtgar, UCL and Royal Free Hospital London; John Fox, University of Oxford
  • Release date: 2010-03-30
  • Status: Draft - Under Review
  • History: Edited on 20/1/2014
Safety case Validated against audit study at Royal Free Hospital (1200 patients)
Sources
  • NICE Clinical guidelines for Breast cancer (early & locally advanced): diagnosis and treatment, CG80 - Issued: February 2009 Breast cancer (early & locally advanced): diagnosis and treatment
  • NCCN guideline for treatment of breast cancer
References