title: Is there a Benefit of Multidisciplinary Cancer Team Meetings for Patients with Gastrointestinal Malignancies?
abstract: Multidisciplinary cancer team meetings are intended to optimize the diagnosis of a patient with a malignancy. The aim of this study was to assess the number of correct diagnoses formulated by the multidisciplinary team (MDT) and whether MDT decisions were implemented.
  
  
  
  In a prospective study, data of consecutive patients discussed at gastrointestinal oncology MDT meetings were studied, and MDT diagnoses were validated with pathology or follow-up. Factors of influence on the correct diagnosis were identified by use of a Poisson regression model. Electronic patient records were used to assess whether MDT decisions were implemented, and reasons to deviate from these decisions were hand-searched within these records.
  
  
  
  In 74 MDT meetings, 551 patients were discussed a total of 691 times. The MDTs formulated a correct diagnosis for 515/551 patients (93.4 %), and for 120/551 (21.8 %) patients the MDT changed the referral diagnosis. Of the MDT diagnoses, 451/515 (87.6 %) were validated with pathology. Patients presented to the MDT by their treating physician were 20 % more likely to receive a correct diagnosis [relative risk (RR) 1.2, 95 % confidence interval (CI) 1.1-1.5], while the number of patients discussed or the duration of the meeting had no influence on this (RR 1.0, 95 % CI 0.99-1.0; RR 1.0, 95 % CI 0.9-1.1; resp.). MDT decisions were implemented in 94.4 % of cases. Deviations of MDT decisions occurred when a patient's wishes or physical condition were not taken into account.
  
  
  
  MDTs rectify 20 % of the referral diagnoses. The presence of the treating physician is the most important factor to ensure a correct diagnosis and adherence to the treatment plan.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.|Gastrointestinal Oncology Center (GIOCA), Academic Medical Center, Amsterdam, The Netherlands.|Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Yara L
authors.initials: YL
authors.lastname: Basta
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Onno L
authors.initials: OL
authors.lastname: Baur
authors.affiliation: Department of Clinical Epidemiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Susan
authors.initials: S
authors.lastname: van Dieren
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.|Department of Surgery, Gelre Ziekenhuizen, Apeldoorn, The Netherlands.
authors.forename: Jean H G
authors.initials: JH
authors.lastname: Klinkenbijl
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.|Gastrointestinal Oncology Center (GIOCA), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. k.m.tytgat@amc.nl.|Gastrointestinal Oncology Center (GIOCA), Academic Medical Center, Amsterdam, The Netherlands. k.m.tytgat@amc.nl.
authors.forename: Kristien M A J
authors.initials: KM
authors.lastname: Tytgat
mesh_terms: D000368:Aged; D003657:Decision Making; D057286:Electronic Health Records; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008495:Medical Oncology / Q000592:standards; D008875:Middle Aged; D009426:Netherlands; D010347:Patient Care Planning; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies