The multidisciplinary colposcopy meeting: recommendations for future service provision and an analysis of clinical decision making.
OBJECTIVE
In 2004 the NHS Cervical Screening Programme (NHSCSP) recommended that multidisciplinary meetings should be incorporated into patient management. No data has been provided since then regarding its functionality or benefits. We aim to address this issue.


METHODS
Retrospective review.


METHODS
Jessop Wing colposcopy multidisciplinary meeting (MDM), Sheffield, UK.


METHODS
All women referred to the MDM from September 2003 to September 2009.


METHODS
Retrospective review of the colposcopy database (Sept 2003-Sept 2009), cross-referenced with multidisciplinary team (MDT) letters, patient notes and the hospital results reporting system. Baseline statistics were used for data analysis.


METHODS
Indications for MDT referral; concordance rates from cytopathology and histopathology review; concordance rates between MDT treatment decisions and final patient management.


RESULTS
A total of 535 cases were discussed at 62 MDT meetings during the allocated study period. Discrepancy between referral cytology and cervix punch biopsy was the most common referral (49%). Cytology and histology review concurred with the initial reports in 75.8 and 97.8% of cases, respectively; the MDT decision was concordant with the final patient management in 97% of cases. The main reason for discordance (67%) resulted from patient factors.


CONCLUSIONS
When significant discrepancies exist between colposcopy, cytology and histopathology, then MDT discussion seems pertinent as MDT discussion can lead to the avoidance of over-treatment. To improve timeliness of treatment, MDT meetings should occur at least monthly. The results of each case discussion should be recorded in the patient case notes, the minutes of each meeting should be circulated to all MDT members and a letter describing MDT recommendations must be sent to the colposcopist responsible for patient care.
Palmer
J E
JE
Department of Gynaecological Oncology/Jessop Wing Colposcopy Unit, Sheffield Hospitals NHS Trust, Sheffield, UK.
Wales
K
K
Ellis
K
K
Dudding
N
N
Smith
J
J
Tidy
J A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D003127:Colposcopy / Q000706:statistics & numerical data; D032921:Consensus; D003657:Decision Making; D003661:Decision Support Techniques; D003695:Delivery of Health Care / Q000458:organization & administration*; D055088:Early Detection of Cancer / Q000379:methods*; D004739:England; D005260:Female; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D010349:Patient Compliance; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy; D055815:Young Adult