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多学科团队在不同肿瘤类型中的协作:一项全国性调查分析。

Multidisciplinary team working across different tumour types: analysis of a national survey.

机构信息

Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, London; Department of Urology, Whipps Cross University Hospital, London.

Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, London.

出版信息

Ann Oncol. 2012 May;23(5):1293-1300. doi: 10.1093/annonc/mdr453. Epub 2011 Oct 19.

Abstract

BACKGROUND

Using data from a national survey, this study aimed to address whether the current model for multidisciplinary team (MDT) working is appropriate for all tumour types.

PATIENTS AND METHODS

Responses to the 2009 National Cancer Action Team national survey were analysed by tumour type. Differences indicate lack of consensus between MDT members in different tumour types.

RESULTS

One thousand one hundred and forty-one respondents from breast, gynaecological, colorectal, upper gastrointestinal, urological, head and neck, haematological and lung MDTs were included. One hundred and sixteen of 136 statements demonstrated consensus between respondents in different tumour types. There were no differences regarding the infrastructure for meetings and team governance. Significant consensus was seen for team characteristics, and respondents disagreed regarding certain aspects of meeting organisations and logistics, and patient-centred decision making. Haematology MDT members were outliers in relation to the clinical decision-making process, and lung MDT members disagreed with other tumour types regarding treating patients with advanced disease.

CONCLUSIONS

This analysis reveals strong consensus between MDT members from different tumour types, while also identifying areas that require a more tailored approach, such as the clinical decision-making process, and preparation for and the organisation of MDT meetings. Policymakers should remain sensitive to the needs of health care teams working in individual tumour types.

摘要

背景

本研究利用全国性调查数据,旨在探讨当前多学科团队(MDT)工作模式是否适用于所有肿瘤类型。

方法

对 2009 年国家癌症行动团队全国性调查的应答情况按肿瘤类型进行分析。差异表明,不同肿瘤类型的 MDT 成员之间缺乏共识。

结果

共纳入来自乳腺、妇科、结直肠、上消化道、泌尿、头颈部、血液和肺部 MDT 的 1141 名应答者。136 项陈述中有 116 项在不同肿瘤类型的应答者之间达成共识。在会议基础设施和团队治理方面没有差异。在团队特征方面达成了显著共识,而应答者在会议组织和后勤以及以患者为中心的决策方面存在分歧。血液学 MDT 成员在临床决策过程中表现为离群值,而肺部 MDT 成员在治疗晚期疾病患者方面与其他肿瘤类型存在分歧。

结论

这项分析揭示了来自不同肿瘤类型的 MDT 成员之间存在强烈共识,但也确定了需要更具针对性方法的领域,例如临床决策过程以及 MDT 会议的准备和组织。政策制定者应继续关注在特定肿瘤类型中工作的医疗保健团队的需求。

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