Adapting human multidisciplinary tumor boards to veterinary oncology: a closed-loop framework for integrated decision-making and organizational learning

Samenvatting

Multidisciplinary tumor boards are established in human oncology to integrate information and reasoning from several specialties around patient-level management decisions. Veterinary oncology already relies on multimodal care and specialist collaboration, but there is still limited standardization of how relevant clinical and contextual information should be prospectively integrated, how the reasoning supporting decisions should be documented, how decisions should be revisited as new information emerges, and how completed cases should inform future practice. This Conceptual Analysis proposes an adaptable veterinary multidisciplinary tumor board (VMTB) for dogs and cats with complex oncologic conditions, including solid tumors and selected hematologic malignancies when multidisciplinary input may change, clarify, or contextualize management. The framework distinguishes essential clinical functions from local implementation configuration and uses a modular seven-step pathway beginning with a time-stamped pre-board management intention. Depending on the clinical question, the VMTB may produce a preferred integrated recommendation or a structured set of clinically defensible alternatives. This approach is consistent with the veterinary Spectrum of Care concept, which recognizes that more than one evidence-informed and clinically acceptable management pathway may exist, and provides a structured basis for subsequent owner-centred shared decision-making. Relevant specialist input may be provided on site, remotely, or through structured external consultation. Cases may re-enter clinical review when definitive pathology, treatment response, progression, or other new information could alter current management. This patient-level re-entry is distinct from the post-case return process: review results in organizational learning only when a clinically relevant observation generates a practice change that is subsequently applied and reassessed. The framework does not assume that VMTB review or management change improves clinical outcomes. Initial evaluation should determine whether the VMTB is feasible and timely, whether its influence on decision-making is traceable, whether the owner’s subsequent decision and implementation of the selected plan can be documented, whether essential functions are delivered with fidelity, and whether the post-case return process is completed. Only after reliable implementation has been established should potential clinical benefit be investigated.