title: Does every patient need to be discussed at a multidisciplinary team meeting?
abstract: OBJECTIVE
  To evaluate the clinical impact and cost-effectiveness of a multidisciplinary team (MDT) meeting in a large hospital in the UK.
  
  
  METHODS
  A management plan for colorectal cancer patients was recorded by the supervising surgical consultant prior to the MDT meeting using the available clinical information and the available reports for imaging and histopathology. The recorded outcomes were then compared with the outcomes documented at the subsequent MDT meeting. The cost of the MDT meeting was calculated based on the salaries of individuals involved plus relevant overheads. A range of opportunity costs were considered, the most significant of which was the expenditure required to re-provide direct clinical care displaced by the MDT.
  
  
  RESULTS
  Over a 3 month period a sample of 47 random cases were reviewed from the colorectal MDT. In three patients, there were significant differences between the preliminary consultant decision and the MDT recommendation: in one case management was changed based on further information about patient co-morbidity and performance status. In only one case was there a material alteration to a CT report, which altered management. The annual costs of running this colorectal local MDT alone were estimated at £162,734+ per annum with opportunity costs of at least twice that.
  
  
  CONCLUSIONS
  The costs of MDT meetings are very high producing a small clinical impact. At a time of increasing financial and capacity pressure in healthcare systems, the use of scarce resources may be better deployed elsewhere.
authors.affiliation: Department of Colorectal Surgery, Derriford Hospital, Plymouth Hospitals NHS Trusts, Derriford, UK.
authors.forename: N
authors.initials: N
authors.lastname: Chinai
authors.forename: F
authors.initials: F
authors.lastname: Bintcliffe
authors.forename: E M
authors.initials: EM
authors.lastname: Armstrong
authors.forename: J
authors.initials: J
authors.lastname: Teape
authors.forename: B M
authors.initials: BM
authors.lastname: Jones
authors.forename: K B
authors.initials: KB
authors.lastname: Hosie
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics / Q000628:therapy*; D015897:Comorbidity; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D010348:Patient Care Team / Q000191:economics / Q000458:organization & administration*; D018579:Patient Selection; D011446:Prospective Studies; D006113:United Kingdom