Background
Multidisciplinary meetings (MDMs) play a vital role in cancer care, and there is a growing focus on improving their decision-making efficiency. Various validated tools have been utilised to assess MDM performance across the UK, Austria, Germany, Sweden, and the Netherlands. However, there have been no studies examining this matter within the Australian context. We present a prospective study examining various MDMs across three cancer centres within the South Western Sydney Local Health District.
Methods
This prospective observational study encompassed 14 different MDMs across three cancer centres. For each MDM, two trained observers participated in four meetings, assessing the quality of information presented and the team members’ contributions to cases in real time. This evaluation utilised the validated Metric for the Observation of Decision-Making (MDT-MODe) tool, scoring behaviours on Likert scales, with 5 representing the evidence-based optimal behaviour, and 1 representing behaviour contrary to the defined optimum.
Results
A total of 64 MDMs were observed (N=498 patients), averaging seven cases per meeting (range 2-15), with management decisions made in 99% of the cases. Patient’s psychosocial factors (M = 1.27, SD = 0.70), comorbidities (M = 1.69, SD = 1.13) and patient’s views (M = 1.12, SD = 0.51) were notably less comprehensively addressed compared to radiology (M = 4.10, SD = 1.52), pathology (M = 3.73, SD = 1.54) and patient history (M = 4.60, SD = 0.73) (p < 0.05). Regarding disciplinary contributions, cancer specialist nurses scored considerably lower (M = 1.04, SD = 0.38) compared to other team members (surgeons, M = 3.33; radiation oncologists, M = 3.93; medical oncologists M = 3.05; pathologists, M = 3.34; radiologists, M = 3.74) (p < 0.05).
Conclusion
Evaluating MDMs through observation and a validated tool provides valuable insights into decision-making quality across various MDMs. Our investigation revealed a consistent standard of comprehensive medical information and team contributions, while also highlighting certain areas for improvement. Analysing behaviour ratings across different MDMs will yield further insights into the strengths and weaknesses of each group. These combined findings provide an opportunity for offering feedback to MDMs, facilitating identification of potential interventions for improvement.