Improving outcomes in urological cancers: The impact of “multidisciplinary team meetings”

Acher, Peter; Young, Anthony J.; Etherington-Foy, Russell; McCahy, Philip; Deane, Anthony M.

doi:10.1016/j.ijsu.2005.06.006

Cited by 40 publications

(41 citation statements)

References 6 publications

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“…That result highlights the potential medicolegal implications that may arise as a result of incomplete information. Additionally, two studies concluded that mccs do not have a significant impact on clinical decision-making and that they are therefore not mandatory in patient care 11,24 .…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Management of Cancer Patients: Chasing a Shadow or Real Value? An Overview of the Literature

Croke

El-Sayed

2012

Current Oncology

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Purpose: Multidisciplinary cancer conferences (mccs) are designed to optimize patient outcomes. It appears intuitive that mccs are essential to clinical decision-making and patient management; however, it is unclear whether that belief is supported by evidence. Our objectives were to assess the currently published literature addressing the impact of mccs on clinical decision-making and patient outcomes. Methods: Ovid medline was searched from 1950 to June 2010 using these keywords: “multidisciplinary/interdisciplinary/clinical meeting$/conference$/round$/team$,” “decision making,” “neoplasms$/cancer$/oncology/tumo(u)r conference$/board$/meeting$,” “multidisciplinary/interdisciplinary cancer conference$/meeting$.” All trials, guidelines, metaanalyses, reviews, and prospective and retrospective studies were included. Results: The keywords retrieved 595 abstracts, and 30 manuscripts were obtained. Most of the studies assessed the impact of mccs on clinical decision-making rather than on patient outcomes. Conclusions: Available evidence supports the belief that mccs significantly influence clinical decision-making and treatment recommendations. In contrast, scant evidence suggests that mccs improve patient outcomes. Unfortunately, the current literature is substantially heterogeneous and therefore does not allow for firm conclusions.

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Section: Discussionmentioning

confidence: 99%

Multidisciplinary Management of Cancer Patients: Chasing a Shadow or Real Value? An Overview of the Literature

Croke

El-Sayed

2012

Current Oncology

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“…1,5 Notably, a study of a urological cancer MDT meeting concluded that routine discussion of all cancer cases at MDT meetings made no difference to the clinical management in the majority (98%) of cases, and where management changes did occur, they were in pre-identified complex cases which had been flagged by the clinicians. 23 The authors suggested that a selective rather than a 'blanket' approach to who is discussed at an MDT meeting is appropriate. Anecdotally members of the MDT acknowledge that in ideal circumstances all patients presenting with malignant glioma should be discussed; however as the hospital is a tertiary referral centre this remains impractical.…”

Section: Discussionmentioning

confidence: 99%

Communication in and clinician satisfaction with multidisciplinary team meetings in neuro-oncology

Field

Rosenthal

Dimou

et al. 2010

Journal of Clinical Neuroscience

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“…However, other authors have shown that it rarely alters the primary decision of the treating clinician. 2 Nevertheless, the MDT provides a safeguard against maverick clinicians, with a round-table consensus being reached for every cancer case. The second tier of MDT, the Central or Specialist MDT, requires that certain cases are discussed in a tertiary setting based on strict referral criteria.…”

Section: Discussionmentioning

confidence: 99%

The Central Urology Multidisciplinary Team – Is it Time to Change the Referral Criteria? An Audit of Practice in a District General Hospital in London

Sooriakumaran

Dick

Thompson

et al. 2009

annals

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INTRODUCTION All cancer patients are discussed in multidisciplinary team meetings (MDTs). Certain patients are referred to the Central MDT based on specific national criteria. We wanted to see whether the Central MDT aided in the decision-making process above that of the Local MDT alone. PATIENTS AND METHODS All MDT forms (local and central) for 2007 were retrospectively reviewed. RESULTS A total of 217 patients were reviewed at the Local MDT. Of these 217 cases, 102 (47.0%) cases were referred to the Central MDT and 15 of the 102 (14.7%) cases were awaiting investigations at the time of the Local MDT and were, therefore, excluded. For the prostate cancer cases (n = 67), the Central MDT did not change outright the Local MDT decision in any case, but in 6 of 67 (9.0%), advised/excluded patients from clinical trials. For bladder cancer cases (n = 19), 4 of 19 (21.0%) patients had their management changed by the Central MDT. The one kidney cancer case had its Local MDT decision changed by the Central MDT. CONCLUSIONS This audit suggests that the Central MDT plays a useful role in the decision-making process for bladder and kidney cancers, and helps determine eligibility for clinical trials in metastatic prostate cancer patients. Its value over the Local MDT alone in the decision-making process for non-metastatic prostate cancer is questionable.

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Improving outcomes in urological cancers: The impact of “multidisciplinary team meetings”

Cited by 40 publications

References 6 publications

Multidisciplinary Management of Cancer Patients: Chasing a Shadow or Real Value? An Overview of the Literature

Multidisciplinary Management of Cancer Patients: Chasing a Shadow or Real Value? An Overview of the Literature

Communication in and clinician satisfaction with multidisciplinary team meetings in neuro-oncology

The Central Urology Multidisciplinary Team – Is it Time to Change the Referral Criteria? An Audit of Practice in a District General Hospital in London

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