The effect of digital-enabled multidisciplinary therapy conferences on efficiency and quality of the decision making in prostate-cancer care

Abstract

Objectives To investigate the impact on efficiency and quality of pre-prostatectomy multidisciplinary therapy conferences (MDT) at Karolinska University Hospital related to the use of a digital solution compared to standard of care. Further, to explore whether gains in MDT efficiency and quality impact oncological or functional patient outcomes. Methods We conducted a prospective, observational study of preoperative prostate-cancer MDT at Karolinska between February 2017 and March 2021. We compared efficiency and quality of the standard MDT and the MDT using the digital solution IntelliSpace Precision Medicine Multidisciplinary Team Orchestrator (ISPM) based on the previously used MDT-MODe approach. Clinical and patient-reported functional outcomes were derived from the medical records and the Swedish National Prostate Cancer Register (NPCR). Results While ISPM was used during the multidisciplinary therapy conference, the time spent per patient was reduced by 24 % (p<0.001) and most of the MDT-MODe items were scored significantly higher. There was a reduction in pelvic lymph-node dissection procedures in the ISPM cohort (p=0.001) and an increased proportion of unilateral nerve-sparing procedures (p=0.005), while all other outcome-related measures were not significantly different between the two patient groups. Discussion & Conclusion To increase the value of the MDT, all data relevant for treatment decision need to be purposefully presented and compiled, which also enables secondary use of the data. The use of a digital solution during preoperative MDTs for prostate-cancer decision-making at Karolinska University Hospital improved the efficiency and quality of this multidisciplinary team meeting without impacting patient outcomes.