Multidisciplinary team (MDT) meetings are a central institution in oncological decision-making and considered standard of care. Yet, apart from expert opinion, there is little evidence of factors that contribute to good recommendations, or even criteria that define their quality. Here we examine which factors contribute most to comprehensible decisions that are close to guidelines or provide plausible explanations for diverging, and enable recommendations that are actually followed by members of the MDT.
In this retrospective single institution analysis, we looked at 494 decisions of a visceral oncology MDT meeting in 2020. For every case discussed, we checked 26 predefined factors deemed necessary for effective MDTs in oncology. They were divided into factors related to informational or logistical input into MDT and factors related to the recommendation itself. We performed logistical regression analysis to find correlations between input and output factors. Furthermore, we analyzed which of the input factors contributed significantly to a “good recommendation”.
We found that 65% of recommendations made by our MDT met all the predefined criteria of “good recommendations”. We also found a strong and consistent correlation between logistical and informational input factors and the quality of tumor board output. Most influential in our setting was the presence of all core team members (p < 0.00001), a clear indication of patient wishes (p < 0.01), and the written documentation of important information not submitted at the time of case registration but communicated during the meetings (p < 0.00000001).
Oncological treatment is strongly based on tumor board decisions. Here we demonstrate that analysis of input factors of MDTs provides some insight into which factors mainly influence the quality of recommendations. Future studies will examine if changes in the structure and conduct of our MDT based on this analysis will lead to improved MDT recommendations.
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All authors have declared no conflicts of interest.