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结直肠癌多学科会诊中决策的质量评估

Quality assessment of decision-making in colorectal cancer multidisciplinary meetings.

作者信息

Seretis Charalampos, Mankotia Rajnish, Goonetilleke Kolitha, Rawstorne Edward

机构信息

Department of General Surgery, Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, UK.

出版信息

J BUON. 2014 Oct-Dec;19(4):913-6.

Abstract

PURPOSE

The quality of decision-making in the colorectal multidisciplinary team (MDT) meetings can significantly affect the quality of care delivered to patients with colorectal cancer. We performed a prospective study to assess the quality of the MDT meetings in a specialized colorectal unit using an externally observational validated tool.

METHODS

An externally validated observational tool, the Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess the quality of clinical decision-making in 64 cases.

RESULTS

Although case history information presented by the responsible surgeon was rated high (4.4/5), the quality of radiological and histopathological information regarding each patient's case which was available at the time was less adequate, scoring 3.9/5 and 3.8/5, respectively. Moreover, the precise knowledge of patients' personal views and circumstances was a field requiring further improvement. In a general overview however, the quality and extent of the available information enabled the MDT to provide a clear recommendation regarding the patients' treatment plans in 87.5% of the cases.

CONCLUSIONS

The cMDT-MODe tool can be used to prospectively audit the quality of clinical decision-making in the colorectal MDT meetings and highlight the fields of potential improvement.

摘要

目的

结直肠多学科团队(MDT)会议中的决策质量会显著影响结直肠癌患者所接受治疗的质量。我们开展了一项前瞻性研究,使用一种经过外部验证的观察工具来评估一家专业结直肠科室MDT会议的质量。

方法

采用一种经过外部验证的观察工具——结直肠多学科团队决策观察指标(cMDT-MODe),对64例病例的临床决策质量进行评估。

结果

尽管负责的外科医生提供的病史信息评分较高(4.4/5),但当时可得的关于每位患者病例的放射学和组织病理学信息质量欠佳,分别为3.9/5和3.8/5。此外,对患者个人观点和情况的准确了解是一个需要进一步改进的领域。然而,总体而言,现有信息的质量和范围使MDT能够在87.5%的病例中就患者的治疗方案给出明确建议。

结论

cMDT-MODe工具可用于前瞻性审核结直肠MDT会议中的临床决策质量,并突出潜在的改进领域。

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