Contributions to Multidisciplinary Team Meetings in Cancer Care: Predictors of Complete Case Information and Comprehensive Case Discussions

Abstract

Jessica Wihl,1– 3 Linn Rosell,1,2 Kirsten Frederiksen,4 Sara Kinhult,1,3 Gert Lindell,5 Mef Nilbert1,4,6 1Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden; 2Regional Cancer Centre South, Region Skåne, Lund, Sweden; 3Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden; 4Danish Cancer Society Research Centre, Copenhagen, Denmark; 5Department of Surgery, Skåne University Hospital, Lund, Sweden; 6Clinical Research Centre, Hvidovre University Hospital and Copenhagen University, Copenhagen, DenmarkCorrespondence: Jessica WihlDepartment of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Scheelev. 2, Lund, 223 63, SwedenEmail [email protected]: Multidisciplinary team (MDT) meetings integrate complex information and base recommendations for clinical management on interdisciplinary and multiprofessional decision-making. To support high-quality decision-making and define key performance indicators, we aimed to determine completeness of case information and contributions to MDT case discussions in cancer care.Methods: In a prospective observational study design, based on three MDTs, we applied the Metric for Observation of Decision-Making (MODe) tool to assess the quality of case presentation and team members’ contributions to case discussions. The MDTs handled patients with brain tumors, soft tissue sarcomas and hepatobiliary cancers. The results were correlated to patient and team characteristics and to MDT leadership skills.Results: Data were collected from 349 case discussions during 32 MDT meetings. Information on radiology received the highest scores, followed by case history and information on histopathology. Patient-related information was less frequently mentioned and generally received low scores. Contributions to the case discussions were predominantly by the chair, surgeons, and oncologists with limited contributions from nurses. Leadership skills showed a positive correlation with case presentations scores and failure to reach a treatment recommendation correlated with lower case discussion scores.Conclusion: Considerable resources are spent on MDT meetings in cancer care, which motivate initiatives to ensure high-quality and efficient decision-making processes. We identify unbalanced contributions from team members during MDT meetings, demonstrate limited provision of patient-related information and show that leadership skills may positively influence the quality of the case presentations. We suggest that MDTs should consider and develop these aspects to ensure high-quality MDT-based case management and decision-making.Keywords: tumor board, cancer conference, decision-making, patient-centred, comorbidity

Keywords

• tumor board
• cancer conference
• decision-making
• patient-centred
• comorbidity