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Comparative Study
. 2024 Nov 18;24(1):1423.
doi: 10.1186/s12885-024-13188-4.

Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality

Torben Riis Rasmussen  1   2 , Anja Gouliaev  3 , Erik Jakobsen  4 , Karin Hjorthaug  5 , Lene Unmack Larsen  6 , Peter Meldgaard  7 , Jesper Thygesen  8 , Rana Bibi  9 , Lars B Møller  10 , Arman Arshad  11 , Birgitte Folkersen  3 , Anette Højsgaard  12 , Zaigham Saghir  13 , Klaus R Larsen  14 , Jesper Ravn  15
Affiliations
Comparative Study

Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality

Torben Riis Rasmussen et al. BMC Cancer. .

Abstract

Introduction: This study aimed to evaluate the consistency of lung cancer case assessments across multidisciplinary team (MDT) sites in Denmark. The goal was to appraise the comparability of outcomes between hospitals in a real-world context.

Methods: We prepared sixty comprehensive, fictitious lung cancer case stories, complete with images, and distributed them to the four primary lung cancer MDT conferences in Denmark. These cases were subsequently evaluated as had they been ordinary patients during regular MDT meetings. We compared the conclusions on assigned TNM stage and proposed treatment intent using Kappa statistics.

Results: The consensus on assigned stage (Stages IA-B, IIA-B, IIIA-B, IV, and undetermined) corresponded to a Fleiss' Kappa-value of 0.62 (95% CI: 0.52-0.71). The overall assessment of curability, categorized as Curable, Incurable, and Undetermined, corresponded to a Kappa-value of 0.72 (CI: 0.61-0.84). However, for cases unanimously judged by all MDT sites to be Stage III, the concordance on treatment intent was poor, with an agreement coefficient of only 0.32 (95% CI: -0.27-0.97).

Conclusion: In detail, the level of agreement on assigned stages was less than desired. In consequence, comparative analyses of treatment results from different hospitals or centres may be prone to bias caused by systematic differences in stage assessment or intent of treatment. The least consensus was observed for cases in Stage III, indicating a need for quality improvement efforts to ensure a higher degree of consistency in MDT decisions.

Keywords: Lung cancer; MDT; Multidisciplinary team meeting; Real world setting.

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Conflict of interest statement

Declarations Ethics approval and consent to participate Not applicable. The study is based on fictitious case stories and associated imaging used in the study are fully and irrevocably anonymized. The Danish National Medical Research Ethics Committee (https://researchethics.dk/) waived the need for ethical approval and referred to the local Institutional Review Board at Aarhus University Hospital (IRB-AUH) for permission to access selected imaging for full and irrevocable anonymization and subsequent use in the study, for which permission was granted. The need for consent to participate was waived by IRB-AUH as it was deemed unnecessary for the intended use according to Danish national regulations (Danish Health Act, § 42 d (https://www.retsinformation.dk/eli/lta/2018/1286#P42d)). The use of fictitious case stories and fully and irrevocable anonymized data for research are permissible under Danish and European General Data Protection Regulation (the GPDR rules – REGULATION (EU) 2016/679 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 27 April 2016, article 26 (https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32016R0679)). Consent for publication Not applicable. The study is based on fictitious case stories and fully and irrevocably anonymized images, the use of which is permissible under Danish and European GDPR rules as stated and explained above for ‘Ethics approval and consent to participate’. Competing interests The authors declare no competing interests. Authors information Each author is a senior consultant with extensive experience in lung cancer diagnostics at university hospitals or is conducting research into the function of MDT in lung cancer.

Figures

Fig. 1
Fig. 1
Example of a case presentation
See this image and copyright information in PMC

References

    1. Scott Bir B. Multidisciplinary Team Approach in Cancer Care: A Review of the Latest Advancements Featured at ESMO 2021. 2022 Mar 21 [cited 2024 Sep 21]; https://www.emjreviews.com/oncology/symposium/multidisciplinary-team-app...
    1. Walraven JEW, Desar IME, van der Hoeven JJM, Aben KKH, Hillegersberg van R, Rasch CRN, et al. Analysis of 105.000 patients with cancer: have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands. Eur J Cancer Oxf Engl 1990. 2019;121:85–93. - PubMed
    1. Forrest LM, McMillan DC, McArdle CS, Dunlop DJ. An evaluation of the impact of a multidisciplinary team, in a single centre, on treatment and survival in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2005;93(9):977–8. - PMC - PubMed
    1. Heinke MY, Vinod SK. A review on the impact of lung cancer multidisciplinary care on patient outcomes. Transl Lung Cancer Res. 2020;9(4):1639–53. - PMC - PubMed
    1. Schmidt HM, Roberts JM, Bodnar AM, Kunz S, Kirtland SH, Koehler RP, et al. Thoracic multidisciplinary tumor board routinely impacts therapeutic plans in patients with lung and esophageal cancer: a prospective cohort study. Ann Thorac Surg. 2015;99(5):1719–24. - PubMed

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