Influence of endocrine multidisciplinary tumor board on patient management and treatment decision making

1. In a cohort of thyroid cancer patients, multidisciplinary tumor boards were associated with changes in their management plan and improved clinician knowledge.

Evidence Rating Level: 2 (Good)

Multidisciplinary Tumor Boards (MDT), consisting of several healthcare specialists, are frequently used in medicine when managing patients with various cancers. They have been shown to significantly influence treatment plans for patients, increase patient and physician satisfaction, and may also improve survival. Although thyroid cancer is quite prevalent worldwide, there is limited research to establish guidelines for management, and thus, it would benefit from MDT. This study aimed to assess an Endocrine MDT for alterations in management on thyroid cancer cases based on its recommendations. The study included 286 presentations of thyroid carcinoma, 70% of which were women and 6.7% of which were pediatric cases. The primary outcome measured was the incidence of change in management after presentation of the case at MDT. It was found that management chance was recommended in 49 (15%) of MDT presentation, with the most common alteration being request for additional imaging (42.5%). Secondary outcomes measured were patient characteristics associated with higher likelihood of change in management, evaluation of the frequency of various types of change in management, attendee perception of the usefulness of MDT, and any changes in their clinical practice because of MDT. There were no significant associations between management plan changes and patient characteristics. The study evaluated 91 evaluations of the MDT from attendees. 54 attendees (59.3%) indicated regular attendance in the MDT meetings and 99% of attendees indicated improvement in their patient care and teaching due to the MDT. Additionally, 28.9% of attendees indicated management changes learned from the MDT and 21% indicated changes in their planned imaging work-up. Therefore, the study is one of the first to conclude that MDT presentations led to higher rate of management changes in thyroid cancer patients and were associated with increased evidence-based practices among clinicians.

Click to read the study in the American Journal of Surgery

Image: PD

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