An audit of urological MDT decision making in the South West of England

Luke Hounsome, Julia Verne, Raj Persad, Amit Bahl, David Gillatt, Jon Oxley, Ru Macdonagh, John Graham, Richard Pocock

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: The formation of multidisciplinary teams (MDTs) was formalised for urological cancer services by the National Institute for Health and Care Excellence (NICE) in the 2002 Improving Outcomes in Urological Cancer guidance. This project aimed to assess the variability of MDT recommendations when presented with the same patient. It covered the type and grade of tumour, recorded stage, treatment recommendations and whether clinical trials were considered. Materials and methods: Anonymised details of 10 patients were sent to South West Trust MDTs in two tranches. Details included age, clinical history, haematology and biochemistry results, digital radiology, and pathology text. A panel of representative urologists and urological oncologists from the region decided on optimal treatment and key points of management decisions. Results: The MDTs were not consistent in decision making. This agrees with a previous survey of urologists which also showed inconsistent decision making, and under-use of clinical cues. Some decisions contradicted NICE guidelines in force at the time. Conclusions: MDTs are now an instrumental, integrated part of cancer management. It is vital for assurance of best patient care and best outcomes that the MDT considering and planning treatment is fully functional and well informed on the evidence base, with effective communications. This audit suggests that this is not the case. The Oxford Centre for Evidence-based Medicine – Levels of Evidence is not applicable to this study.

LanguageEnglish
Pages254-257
Number of pages4
JournalJournal of Clinical Urology
Volume11
Issue number4
Early online date1 Jan 2018
DOIs
Publication statusPublished - 1 Jul 2018
Externally publishedYes

Fingerprint

England
Urologic Neoplasms
Decision Making
National Institutes of Health (U.S.)
Delivery of Health Care
Evidence-Based Medicine
Hematology
Radiology
Biochemistry
Cues
Neoplasms
Patient Care
Therapeutics
Communication
Clinical Trials
Guidelines
Pathology
Urologists
Oncologists
Surveys and Questionnaires

Keywords

  • Bladder cancer
  • cancer
  • core urology
  • decision making
  • MDT
  • prostate cancer

Cite this

Hounsome, L., Verne, J., Persad, R., Bahl, A., Gillatt, D., Oxley, J., ... Pocock, R. (2018). An audit of urological MDT decision making in the South West of England. Journal of Clinical Urology, 11(4), 254-257. https://doi.org/10.1177/2051415818755626
Hounsome, Luke ; Verne, Julia ; Persad, Raj ; Bahl, Amit ; Gillatt, David ; Oxley, Jon ; Macdonagh, Ru ; Graham, John ; Pocock, Richard. / An audit of urological MDT decision making in the South West of England. In: Journal of Clinical Urology. 2018 ; Vol. 11, No. 4. pp. 254-257.
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abstract = "Objective: The formation of multidisciplinary teams (MDTs) was formalised for urological cancer services by the National Institute for Health and Care Excellence (NICE) in the 2002 Improving Outcomes in Urological Cancer guidance. This project aimed to assess the variability of MDT recommendations when presented with the same patient. It covered the type and grade of tumour, recorded stage, treatment recommendations and whether clinical trials were considered. Materials and methods: Anonymised details of 10 patients were sent to South West Trust MDTs in two tranches. Details included age, clinical history, haematology and biochemistry results, digital radiology, and pathology text. A panel of representative urologists and urological oncologists from the region decided on optimal treatment and key points of management decisions. Results: The MDTs were not consistent in decision making. This agrees with a previous survey of urologists which also showed inconsistent decision making, and under-use of clinical cues. Some decisions contradicted NICE guidelines in force at the time. Conclusions: MDTs are now an instrumental, integrated part of cancer management. It is vital for assurance of best patient care and best outcomes that the MDT considering and planning treatment is fully functional and well informed on the evidence base, with effective communications. This audit suggests that this is not the case. The Oxford Centre for Evidence-based Medicine – Levels of Evidence is not applicable to this study.",
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Hounsome, L, Verne, J, Persad, R, Bahl, A, Gillatt, D, Oxley, J, Macdonagh, R, Graham, J & Pocock, R 2018, 'An audit of urological MDT decision making in the South West of England', Journal of Clinical Urology, vol. 11, no. 4, pp. 254-257. https://doi.org/10.1177/2051415818755626

An audit of urological MDT decision making in the South West of England. / Hounsome, Luke; Verne, Julia; Persad, Raj; Bahl, Amit; Gillatt, David; Oxley, Jon; Macdonagh, Ru; Graham, John; Pocock, Richard.

In: Journal of Clinical Urology, Vol. 11, No. 4, 01.07.2018, p. 254-257.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - An audit of urological MDT decision making in the South West of England

AU - Hounsome, Luke

AU - Verne, Julia

AU - Persad, Raj

AU - Bahl, Amit

AU - Gillatt, David

AU - Oxley, Jon

AU - Macdonagh, Ru

AU - Graham, John

AU - Pocock, Richard

PY - 2018/7/1

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