Multidisciplinary team meeting in digestive oncology: when opinions differ.
In daily oncology, Multidisciplinary Team (MDT) meetings are used worldwide to take every main decision. In order to improve the MDT efficiency, an analysis of decision-making process relying on patients refusing to undergo MDT proposal during presentations, in accordance with their referent specialist, was retrospectively performed in an academic and tertiary center, from 1995 to 2010. Out of 1000 patients, 0.5% refused the MDT proposal because of (1) ignorance of current evidence-based literature, (2) heterogeneous interpretations of the technical feasibility, and (3) the MDT undervaluing patient's specificities and wishes. In order to offset the MDT decision, patient needs to come from a well-off and educated background and to get the uttered support of the referent specialist. MDT conclusion is not customized because of interindividual exceptions and technical evaluations. Clinical Nurse Specialists attending to "blind" MDT meetings may help to back oncologic patient's specificities and wishes.
Digestive Surgery Unit, Antoine Béclère Hospital, Clamart, Assistance Publique - Hôpitaux de Paris, University Paris XI, Paris, France; Medical Ethics and Legal Medicine Laboratory, University Paris V Descartes, Paris, France.
Alban
A
Zarzavadjian Le Bian
Renato
R
Costi
Audrey
A
Bruderer
Christian
C
Herve
Claude
C
Smadja
D000328:Adult; D003657:Decision Making; D004067:Digestive System Neoplasms / Q000451:nursing; D034462:Dissent and Disputes; D005260:Female; D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009723:Nurse-Patient Relations; D057240:Patient Preference
decision-making process; multidisciplinary team; oncology