Development of the First Quality Assessment Framework for the Endocarditis Multidisciplinary Team Meeting
Abstract
Objectives: Endocarditis is increasing in incidence with substantial morbidity and mortality. The endocarditis multidisciplinary team (MDT) is a core guideline recommendation with clear patient outcome benefits by expediting diagnosis, coordinating investigations and management. There is significant variability in content and specialist input, with no validated metric available to assess decision-making or demonstrate improvement over time. Multidisciplinary Team Metric for the Observation of Decision-making (MDT-MODe) is a validated quality assessment tool extensively utilized for cancer MDTs. This paper describes the adaptation of the psychometrically tested MDT-MODe to an endocarditis setting, resulting in the development of MDT-MODIE (Metric for the Observation of Decision-making for Infective Endocarditis).
Methods: An expert interview panel was engaged at a single high-volume London centre. Domains were assessed and analysed using a content validity index, through which the final MDT-MODIE was defined. Feasibility testing was conducted during MDTs between September 2024 and April 2025. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs), while internal validation was evaluated through point-biserial correlation coefficients. Statistical analyses were performed using IBM SPSS Statistics (version 29.0).
Results: Domains scored as excellent or good were included in MDT-MODIE. Feasibility and reliability testing was performed with 152 patient discussions assessed, and scores matched to decision outcomes for each patient. Inter-rater reliability was confirmed across all domains (P < .001). Internal validation demonstrated a positive correlation between overall MODIE scores and MDT decision-making outcomes (rpb(96) = 0.216, P = .033).
Conclusions: Metric for the Observation of Decision-making for Infective Endocarditis provides a reliable framework for evaluating endocarditis MDT decision-making, which has undergone preliminary validation. It addresses a key gap in the literature, supporting cardiac centres in assessing the quality of guideline-recommended MDTs and monitoring improvement over time.
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BibTeX
@article{rizzo2026development,
title = {{Development of the First Quality Assessment Framework for the Endocarditis Multidisciplinary Team Meeting}},
author = {Victoria Rizzo and Evgeny Raevsky and Christopher Primus and Ceri Davies and Satya Das and Cristina Suarez and Shirish Ambekar and Neil Roberts and Nandor Marczin and Rakesh Uppal and Kulvinder Lall and Simon Woldman and Thanos Athanasiou and Tayana Soukup},
journal = {Interdisciplinary Cardiovascular and Thoracic Surgery},
year = {2026},
month = sep,
doi = {10.1093/icvts/ivag219},
url = {https://doi.org/10.1093/icvts/ivag219},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Development of the First Quality Assessment Framework for the Endocarditis Multidisciplinary Team Meeting
AU - Victoria Rizzo
AU - Evgeny Raevsky
AU - Christopher Primus
AU - Ceri Davies
AU - Satya Das
AU - Cristina Suarez
AU - Shirish Ambekar
AU - Neil Roberts
AU - Nandor Marczin
AU - Rakesh Uppal
AU - Kulvinder Lall
AU - Simon Woldman
AU - Thanos Athanasiou
AU - Tayana Soukup
PY - 2026
DA - 2026/09/10
JO - Interdisciplinary Cardiovascular and Thoracic Surgery
DO - 10.1093/icvts/ivag219
UR - https://doi.org/10.1093/icvts/ivag219
AB - Objectives: Endocarditis is increasing in incidence with substantial morbidity and mortality. The endocarditis multidisciplinary team (MDT) is a core guideline recommendation with clear patient outcome benefits by expediting diagnosis, coordinating investigations and management. There is significant variability in content and specialist input, with no validated metric available to assess decision-making or demonstrate improvement over time. Multidisciplinary Team Metric for the Observation of Decision-making (MDT-MODe) is a validated quality assessment tool extensively utilized for cancer MDTs. This paper describes the adaptation of the psychometrically tested MDT-MODe to an endocarditis setting, resulting in the development of MDT-MODIE (Metric for the Observation of Decision-making for Infective Endocarditis). Methods: An expert interview panel was engaged at a single high-volume London centre. Domains were assessed and analysed using a content validity index, through which the final MDT-MODIE was defined. Feasibility testing was conducted during MDTs between September 2024 and April 2025. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs), while internal validation was evaluated through point-biserial correlation coefficients. Statistical analyses were performed using IBM SPSS Statistics (version 29.0). Results: Domains scored as excellent or good were included in MDT-MODIE. Feasibility and reliability testing was performed with 152 patient discussions assessed, and scores matched to decision outcomes for each patient. Inter-rater reliability was confirmed across all domains (P < .001). Internal validation demonstrated a positive correlation between overall MODIE scores and MDT decision-making outcomes (rpb(96) = 0.216, P = .033). Conclusions: Metric for the Observation of Decision-making for Infective Endocarditis provides a reliable framework for evaluating endocarditis MDT decision-making, which has undergone preliminary validation. It addresses a key gap in the literature, supporting cardiac centres in assessing the quality of guideline-recommended MDTs and monitoring improvement over time.
SN - 2753-670X
ER -