Stalfors Joacim, Lundberg Christer, Westin Thomas
Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenbur, Sweden.
Acta Otolaryngol. 2007 Jan;127(1):82-7. doi: 10.1080/00016480600740589.
Head and neck oncology MDT meetings are held in our region to establish a correct diagnosis and an appropriate treatment plan for each reviewed patient. The quality of these MDT meetings was assessed based on the following factors: How often can a diagnosis, a TNM-classification and a treatment plan be successfully established from the workup presented at the patient's first MDT meeting? And what are the reasons for failure? Further, how often are the TNM-classification altered at treatment start? All patients (n=329) presented at MDT meetings during one year were included prospectively and data were collected in a protocol. As telemedicine recently was introduced to reduce travel, any eventual impact on quality on decisions with regard to telemedicine were also studied. A diagnosis and a treatment plan could be established for 236 (73%) of 324 patients at the first MDT meeting. TNM classification was revised in four patients (1.4%) before treatment. In conclusion, the validity of decisions made at the MDT meeting is satisfactory, but improvements regarding the quality of workups are possible. The mode of presentation of patients at the MDT meeting was not decisive for the quality of decisions regarding diagnosis and treatment plans.
我们所在地区会召开头颈肿瘤多学科诊疗（MDT）会议，以便为每位接受评估的患者确立正确的诊断和合适的治疗方案。这些MDT会议的质量基于以下因素进行评估：根据患者首次MDT会议上所提供的检查结果，能成功确立诊断、TNM分期和治疗方案的频率如何？失败的原因是什么？此外，治疗开始时TNM分期改变的频率是多少？前瞻性纳入了一年内参加MDT会议的所有患者（n = 329），并按照方案收集数据。由于最近引入了远程医疗以减少出行，因此还研究了其对决策质量的任何潜在影响。在首次MDT会议上，324例患者中的236例（73%）确立了诊断和治疗方案。4例患者（1.4%）在治疗前修订了TNM分期。总之，MDT会议做出的决策有效性令人满意，但检查结果的质量仍有提升空间。患者在MDT会议上的展示方式对于诊断和治疗方案决策的质量并非决定性因素。
