The Experts below are selected from a list of 62160 Experts worldwide ranked by ideXlab platform
Nick Sevdalis - One of the best experts on this subject based on the ideXlab platform.
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Using peer observers to assess the quality of cancer multidisciplinary team meetings: a qualitative proof of concept study
Journal of multidisciplinary healthcare, 2014Co-Authors: Jenny Harris, James S.a. Green, Nick Sevdalis, Cath TaylorAbstract:Background Multidisciplinary team (MDT) working is well established as the foundation for providing cancer services in the UK and elsewhere. A core activity is the weekly meeting (or case conference/tumor boards) where the treatment recommendations for individual patients are agreed. Evidence suggests that the quality of team working varies across cancer teams, and this may impact negatively on the decision-making process, and ultimately patient care. Feedback on performance by expert observers may improve performance, but can be resource-intensive to implement. This proof of concept study sought to: develop a structured Observational Assessment tool for use by peers (managers or clinicians from the local workforce) and explore its usability; assess the feasibility of the principle of Observational Assessment by peers; and explore the views of MDT members and observers about the utility of feedback from Observational Assessment. Methods For tool development, the content was informed by national clinical consensus recommendations for best practice in cancer MDTs and developed in collaboration with an expert steering group. It consisted of ten subdomains of team working observable in MDT meetings that were rated on a 10-point scale (very poor to very good). For Observational Assessment, a total of 19 peer observers used the tool (assessing performance in 20 cancer teams from four hospitals). For evaluation, telephone interviews with 64 team members and all peer observers were analyzed thematically. Results The tool was easy to use and areas for refinement were identified. Peer observers were identified and most indicated that undertaking observation was feasible. MDT members generally reported that Observational Assessment and feedback was useful, with the potential to facilitate improvements in team working. Conclusion This study suggests that observation and feedback by peers may provide a feasible and acceptable approach to enhance MDT performance. Further tool refinement and validation is required.
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Decision-making in Colorectal Cancer Tumor Board meetings: Results of a prospective Observational Assessment
Surgical endoscopy, 2014Co-Authors: S. Shah, S. Arora, G. Atkin, R. Glynne-jones, P. Mathur, Ara Darzi, Nick SevdalisAbstract:Background The management of colorectal cancer increasingly involves multidisciplinary tumor boards. In cases where these occur, the quality can be variable. Despite this, there are no uniform measures to evaluate them. The aim of this study was to evaluate the performance of colorectal cancer tumor boards, via real-time prospective observation.
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teamwork and team performance in multidisciplinary cancer teams development and evaluation of an Observational Assessment tool
BMJ Quality & Safety, 2011Co-Authors: Benjamin W Lamb, Charles Vincent, Helen W. L. Wong, J S Green, Nick SevdalisAbstract:Aim Team performance is important in multidisciplinary teams (MDTs), but no tools exist for Assessment. Our objective was to construct a robust tool for scientific Assessment of MDT performance. Materials and methods An Observational tool was developed to assess performance in MDTs. Behaviours were scored on Likert scales, with objective anchors. Five MDT meetings (112 cases) were observed by a surgeon and a psychologist. The presentation of case history, radiological and pathological information, chair's effectiveness, and contributions to decision-making of surgeons, oncologists, radiologists, pathologists and clinical nurse specialists (CNSs) are analysed via descriptive statistics, a comparison of average scores (Mann–Whitney U) to test interobserver agreement and intraclass correlation coefficients (ICCs) to further assess interobserver agreement and learning curves. Results Contributions of surgeons, chair's effectiveness, presentation of case history and radiological information were rated above average (p≤0.001). Contributions of histopathologists and CNS were rated below average (p≤0.001), and others average. The interobserver agreement was high (ICC=0.70+) for presentation of radiological information, and contribution of oncologists, radiologists, pathologists and CNSs; adequate for case history presentation (ICC=0.68) and contribution of surgeons (ICC=0.69); moderate for chairperson (ICC=0.52); and poor for pathological information (ICC=0.31). Average differences were found only for case-history presentation (p≤0.001). ICCs improved significantly in Assessment of case history, and Oncologists, and ICCs were consistently high for CNS, Radiologists, and Histopathologists. Conclusions Scientific Observational metrics can be reliably used by medical and non-medical observers in cancer MDTs. Such robust Assessment tools provide part of a toolkit for team evaluation and enhancement.
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Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an Observational Assessment tool
BMJ quality & safety, 2011Co-Authors: Benjamin W Lamb, Charles Vincent, Helen W. L. Wong, James Green, Nick SevdalisAbstract:Team performance is important in multidisciplinary teams (MDTs), but no tools exist for Assessment. Our objective was to construct a robust tool for scientific Assessment of MDT performance. An Observational tool was developed to assess performance in MDTs. Behaviours were scored on Likert scales, with objective anchors. Five MDT meetings (112 cases) were observed by a surgeon and a psychologist. The presentation of case history, radiological and pathological information, chair's effectiveness, and contributions to decision-making of surgeons, oncologists, radiologists, pathologists and clinical nurse specialists (CNSs) are analysed via descriptive statistics, a comparison of average scores (Mann-Whitney U) to test interobserver agreement and intraclass correlation coefficients (ICCs) to further assess interobserver agreement and learning curves. Contributions of surgeons, chair's effectiveness, presentation of case history and radiological information were rated above average (p ≤ 0.001). Contributions of histopathologists and CNS were rated below average (p ≤ 0.001), and others average. The interobserver agreement was high (ICC = 0.70+) for presentation of radiological information, and contribution of oncologists, radiologists, pathologists and CNSs; adequate for case history presentation (ICC = 0.68) and contribution of surgeons (ICC = 0.69); moderate for chairperson (ICC = 0.52); and poor for pathological information (ICC = 0.31). Average differences were found only for case-history presentation (p ≤ 0.001). ICCs improved significantly in Assessment of case history, and Oncologists, and ICCs were consistently high for CNS, Radiologists, and Histopathologists. Scientific Observational metrics can be reliably used by medical and non-medical observers in cancer MDTs. Such robust Assessment tools provide part of a toolkit for team evaluation and enhancement.
Lewis Lightner - One of the best experts on this subject based on the ideXlab platform.
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Cyber Teaming and Role Specialization in a Cyber Security Defense Competition
Frontiers in Psychology, 2018Co-Authors: Norbou Buchler, Blaine Hoffman, Claire Genevieve La Fleur, Prashanth Rajivan, Laura R. Marusich, Lewis LightnerAbstract:A critical requirement for developing a cyber capable workforce is to understand how to challenge, assess, and rapidly develop human cyber skill-sets in realistic cyber operational environments. Fortunately, cyber team competitions make use of simulated operational environments with scoring criteria of task performance that objectively define overall team effectiveness, thus providing the means and context for observation and analysis of cyber teaming. Such competitions allow researchers to address the key determinants that make a cyber defense team more or less effective in responding to and mitigating cyber attacks. For this purpose, we analyzed data collected at the 12th annual Mid-Atlantic Collegiate Cyber Defense Competition (MACCDC, http://www.maccdc.org), where eight teams were evaluated along four independent scoring dimensions: maintaining services, incident response, scenario injects, and thwarting adversarial activities. Data collected from the 13-point OAT (Observational Assessment of Teamwork) instrument by embedded observers and a cyber teamwork survey completed by all participants were used to assess teamwork and leadership behaviors and team composition and work processes, respectively. The scores from the competition were used as an outcome measure in our analysis to extract key features of team process, structure, leadership, and skill-sets in relation to effective cyber defense. We used Bayesian regression to relate scored performance during the competition to team skill composition, team experience level, and an Observational construct of team collaboration. Our results indicate that effective collaboration, experience, and functional role-specialization within the teams are important factors that determine the success of these teams in the competition and are important Observational predictors of the timely detection and effective mitigation of ongoing cyber attacks. These results support theories of team development applied to mastering cybersecurity.
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Sociometrics and Observational Assessment of teaming and leadership in a cyber security defense competition
Computers & Security, 2018Co-Authors: Norbou Buchler, Prashanth Rajivan, Lewis Lightner, Laura R. Marusich, Cleotilde GonzalezAbstract:Abstract Advancing our understanding about the human dynamics of cyber security is a major research challenge. At this point, it is unclear how cyber defense teams are organized and led in coordinating and working together to mount and conduct an effective cyber defense. Therefore, we do not know what makes a cyber defense team more or less effective in responding to and mitigating cyber attacks. Cyber competitions offer an approach to train and evaluate the performance of cyber defense teams; such competitions are now regularly conducted at the high school, college, professional, and military defense levels. These naturalistic exercises of teamwork for cyber defense represent an important source for understanding the way defense teams form, coordinate and organize, and to determine the factors that make teams more or less successful. For this purpose, we participated in data collection at the Mid-Atlantic Collegiate Cyber Defense Competition (MACCDC) to understand the key features of effective team processes defined by outcome measures of scored team success. We collected data from wearable social sensors to assess face-to-face interactions and using a 16-point teamwork instrument called OAT (Observational Assessment of Teamwork) to assess teamwork and leadership behaviors in cyber defense. Importantly, this being a cyber defense competition, the success of these teams is evaluated along three independent scoring dimensions: (a) Maintaining Services, (b) Incidence Response, and (c) Scenario Injects. Our results indicate that the leadership dimension and face-to-face interactions are important factors that determine the success of these teams. Teams with effective leadership were more successful, and face-to-face interactions emerged as a strong negative predictor of success. Thus, functional specialization within a team and well-guided leadership could be important predictors of timely detection and mitigation of ongoing cyber attacks. Future research should address more concrete aspects of team coordination and evaluation in cyber defense teams.
Norbou Buchler - One of the best experts on this subject based on the ideXlab platform.
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Cyber Teaming and Role Specialization in a Cyber Security Defense Competition
Frontiers in Psychology, 2018Co-Authors: Norbou Buchler, Blaine Hoffman, Claire Genevieve La Fleur, Prashanth Rajivan, Laura R. Marusich, Lewis LightnerAbstract:A critical requirement for developing a cyber capable workforce is to understand how to challenge, assess, and rapidly develop human cyber skill-sets in realistic cyber operational environments. Fortunately, cyber team competitions make use of simulated operational environments with scoring criteria of task performance that objectively define overall team effectiveness, thus providing the means and context for observation and analysis of cyber teaming. Such competitions allow researchers to address the key determinants that make a cyber defense team more or less effective in responding to and mitigating cyber attacks. For this purpose, we analyzed data collected at the 12th annual Mid-Atlantic Collegiate Cyber Defense Competition (MACCDC, http://www.maccdc.org), where eight teams were evaluated along four independent scoring dimensions: maintaining services, incident response, scenario injects, and thwarting adversarial activities. Data collected from the 13-point OAT (Observational Assessment of Teamwork) instrument by embedded observers and a cyber teamwork survey completed by all participants were used to assess teamwork and leadership behaviors and team composition and work processes, respectively. The scores from the competition were used as an outcome measure in our analysis to extract key features of team process, structure, leadership, and skill-sets in relation to effective cyber defense. We used Bayesian regression to relate scored performance during the competition to team skill composition, team experience level, and an Observational construct of team collaboration. Our results indicate that effective collaboration, experience, and functional role-specialization within the teams are important factors that determine the success of these teams in the competition and are important Observational predictors of the timely detection and effective mitigation of ongoing cyber attacks. These results support theories of team development applied to mastering cybersecurity.
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Sociometrics and Observational Assessment of teaming and leadership in a cyber security defense competition
Computers & Security, 2018Co-Authors: Norbou Buchler, Prashanth Rajivan, Lewis Lightner, Laura R. Marusich, Cleotilde GonzalezAbstract:Abstract Advancing our understanding about the human dynamics of cyber security is a major research challenge. At this point, it is unclear how cyber defense teams are organized and led in coordinating and working together to mount and conduct an effective cyber defense. Therefore, we do not know what makes a cyber defense team more or less effective in responding to and mitigating cyber attacks. Cyber competitions offer an approach to train and evaluate the performance of cyber defense teams; such competitions are now regularly conducted at the high school, college, professional, and military defense levels. These naturalistic exercises of teamwork for cyber defense represent an important source for understanding the way defense teams form, coordinate and organize, and to determine the factors that make teams more or less successful. For this purpose, we participated in data collection at the Mid-Atlantic Collegiate Cyber Defense Competition (MACCDC) to understand the key features of effective team processes defined by outcome measures of scored team success. We collected data from wearable social sensors to assess face-to-face interactions and using a 16-point teamwork instrument called OAT (Observational Assessment of Teamwork) to assess teamwork and leadership behaviors in cyber defense. Importantly, this being a cyber defense competition, the success of these teams is evaluated along three independent scoring dimensions: (a) Maintaining Services, (b) Incidence Response, and (c) Scenario Injects. Our results indicate that the leadership dimension and face-to-face interactions are important factors that determine the success of these teams. Teams with effective leadership were more successful, and face-to-face interactions emerged as a strong negative predictor of success. Thus, functional specialization within a team and well-guided leadership could be important predictors of timely detection and mitigation of ongoing cyber attacks. Future research should address more concrete aspects of team coordination and evaluation in cyber defense teams.
Charles Vincent - One of the best experts on this subject based on the ideXlab platform.
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teamwork and team performance in multidisciplinary cancer teams development and evaluation of an Observational Assessment tool
BMJ Quality & Safety, 2011Co-Authors: Benjamin W Lamb, Charles Vincent, Helen W. L. Wong, J S Green, Nick SevdalisAbstract:Aim Team performance is important in multidisciplinary teams (MDTs), but no tools exist for Assessment. Our objective was to construct a robust tool for scientific Assessment of MDT performance. Materials and methods An Observational tool was developed to assess performance in MDTs. Behaviours were scored on Likert scales, with objective anchors. Five MDT meetings (112 cases) were observed by a surgeon and a psychologist. The presentation of case history, radiological and pathological information, chair's effectiveness, and contributions to decision-making of surgeons, oncologists, radiologists, pathologists and clinical nurse specialists (CNSs) are analysed via descriptive statistics, a comparison of average scores (Mann–Whitney U) to test interobserver agreement and intraclass correlation coefficients (ICCs) to further assess interobserver agreement and learning curves. Results Contributions of surgeons, chair's effectiveness, presentation of case history and radiological information were rated above average (p≤0.001). Contributions of histopathologists and CNS were rated below average (p≤0.001), and others average. The interobserver agreement was high (ICC=0.70+) for presentation of radiological information, and contribution of oncologists, radiologists, pathologists and CNSs; adequate for case history presentation (ICC=0.68) and contribution of surgeons (ICC=0.69); moderate for chairperson (ICC=0.52); and poor for pathological information (ICC=0.31). Average differences were found only for case-history presentation (p≤0.001). ICCs improved significantly in Assessment of case history, and Oncologists, and ICCs were consistently high for CNS, Radiologists, and Histopathologists. Conclusions Scientific Observational metrics can be reliably used by medical and non-medical observers in cancer MDTs. Such robust Assessment tools provide part of a toolkit for team evaluation and enhancement.
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Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an Observational Assessment tool
BMJ quality & safety, 2011Co-Authors: Benjamin W Lamb, Charles Vincent, Helen W. L. Wong, James Green, Nick SevdalisAbstract:Team performance is important in multidisciplinary teams (MDTs), but no tools exist for Assessment. Our objective was to construct a robust tool for scientific Assessment of MDT performance. An Observational tool was developed to assess performance in MDTs. Behaviours were scored on Likert scales, with objective anchors. Five MDT meetings (112 cases) were observed by a surgeon and a psychologist. The presentation of case history, radiological and pathological information, chair's effectiveness, and contributions to decision-making of surgeons, oncologists, radiologists, pathologists and clinical nurse specialists (CNSs) are analysed via descriptive statistics, a comparison of average scores (Mann-Whitney U) to test interobserver agreement and intraclass correlation coefficients (ICCs) to further assess interobserver agreement and learning curves. Contributions of surgeons, chair's effectiveness, presentation of case history and radiological information were rated above average (p ≤ 0.001). Contributions of histopathologists and CNS were rated below average (p ≤ 0.001), and others average. The interobserver agreement was high (ICC = 0.70+) for presentation of radiological information, and contribution of oncologists, radiologists, pathologists and CNSs; adequate for case history presentation (ICC = 0.68) and contribution of surgeons (ICC = 0.69); moderate for chairperson (ICC = 0.52); and poor for pathological information (ICC = 0.31). Average differences were found only for case-history presentation (p ≤ 0.001). ICCs improved significantly in Assessment of case history, and Oncologists, and ICCs were consistently high for CNS, Radiologists, and Histopathologists. Scientific Observational metrics can be reliably used by medical and non-medical observers in cancer MDTs. Such robust Assessment tools provide part of a toolkit for team evaluation and enhancement.
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Observational Assessment of Surgical Teamwork: A Feasibility Study
World journal of surgery, 2006Co-Authors: Shabnam Undre, Andrew N. Healey, Ara Darzi, Charles VincentAbstract:Background Teamwork is fundamental to effective surgery, yet there are currently no measures of teamwork to guide training, evaluate team interventions or assess the impact of teamwork on outcomes. We report the first steps in the development of an Observational Assessment of teamwork and preliminary findings.
Khalid A. Kheirallah - One of the best experts on this subject based on the ideXlab platform.
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Generic Imatinib Therapy Among Jordanians: An Observational Assessment of Efficacy and Safety in Routine Clinical Practice
Clinical lymphoma myeloma & leukemia, 2017Co-Authors: Abdallah Awidi, Salah Abbasi, Kamal Al-rabi, Khalid A. KheirallahAbstract:Abstract Introduction Generic imatinib therapy is being globally considered owing to cost considerations. However, evidence of its efficacy and safety in Middle Eastern clinical settings is scarce. Patients and Methods The efficacy and safety of generic imatinib (Cemivil) were assessed among Jordanian patients diagnosed with chronic myeloid leukemia using an Observational, multicenter, prospective study design. Responses were defined using European LeukemiaNet 2009 guidelines and assessed by complete blood counts, fluorescence in situ hybridization, and real-time quantitative polymerase chain reaction. Results All patients (N = 91) were adults with chronic myeloid leukemia treated with generic imatinib 400 mg/day. Thirty-three patients received generic imatinib as first-line therapy, and 58 switched from patented imatinib to generic imatinib after a median of 4.5 years (range, 0.5-13.6 years) of imatinib therapy. The majority (85%; n = 28) of the first-line patients achieved complete hematologic response within 3 months of starting generic imatinib therapy (100% after 6 months [n = 33]). The 12-month major molecular response rate in the intention-to-treat population was 45%. The 12-month major molecular response rate was 88% for patients who switched therapy. The 12-month progression-free and overall survival rates were 92% and 100%, respectively. Most (85%; n = 144) adverse events were mild. Frequencies of drug-related adverse events were similar to patented imatinib. Conclusion This study suggests that the efficacy and safety of generic imatinib in this Middle Eastern population in routine clinical practice are comparable to patented imatinib, and to that of the global population.
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Generic imatinib therapy among Jordanians: An Observational Assessment of safety and efficacy in routine clinical practice.
Journal of Clinical Oncology, 2017Co-Authors: Abdallah Awidi, Salah Abbasi, Kamal Al-rabi, Khalid A. KheirallahAbstract:e18548Background: Generic imatinib therapy is being globally considered due to cost considerations. Evidence about its efficacy and safety in developing country settings, however, is scarce. Method...
