Discussion on online and offline combined multidisciplinary team diagnosis-treatment mode for cancers

Abstract

Abstract:

ObjectiveTo discuss the feasibility of using online and offline combined multidisciplinary team (MDT) diagnosis-treatment mode in cancers diagnosis and treatment by comparing the comprehensive diagnosis and treatment plans formulated by online and offline MDT diagnosis-treatment mode.MethodsA total of 168 esophageal cancer patients collected from March 17, 2020 to May 17, 2020 were took as the research objects in Shandong Cancer Hospital and Institute, through whom the consistency of the comprehensive diagnosis and treatment plans formulated by online and offline MDT diagnosis-treatment mode was evaluated. The clinical characteristics of patients with changed comprehensive diagnosis and treatment plans, such as age, Karnofsky performance status (KPS) score, whether combined with basic diseases, whether received anti-tumor treatment before and tumor location were analyzed, so as to explore the mechanism to improve the efficiency on the basis of quality assurance.ResultsThe results showed that 86.3% (145/168) of the comprehensive diagnosis and treatment plans obtained by offline MDT diagnosis-treatment mode were consistent with online diagnosis-treatment MDT mode. Cases with inconsistent comprehensive diagnosis and treatment plans were characterized by elderly (> 69 years) (χ²=4.250,P=0.039), KPS score≥80 (χ²=15.520,P<0.001) and combined with underlying disease (χ²=7.135,P=0.008). Through further analysis, the changed cases were also characterized as with inadequate auxiliary examination or complex in imaging.ConclusionThe online and offline combined MDT diagnosis-treatment mode is feasible. For the patients characterized of elderly (> 69 years old), KPS score ≥80, combined with underlying diseases, with incomplete auxiliary examination or complex in imaging, the offline MDT diagnosis-treatment mode should be adopted or supplemented.

Key words:Neoplasm,Multidisciplinary team,Diagnosis,Therapy

Yang Guanghui, Wang Qian, Li Zheqi, Liu Chengxin, Sun Hongfu, Li Zhe, Zhang Haibo, Li Hongsheng, Li Baosheng. Discussion on online and offline combined multidisciplinary team diagnosis-treatment mode for cancers[J]. Journal of International Oncology, 2020, 47(9): 542-545.

Figures/Tables1

项目	诊疗方案改变(n=23)	诊疗方案未变(n=145)	χ²值	P值
年龄(岁)
≤69	16(69.6)	128(88.3)	4.250	0.039
>69	7(30.4)	17(11.7)
KPS评分
<80	3(13.0)	83(57.2)	15.520	<0.001
≥80	20(87.0)	62(42.8)
是否合并基础疾病
是	15(65.2)	52(35.9)	7.135	0.008
否	8(34.8)	93(64.1)
入院前是否接受抗肿瘤治疗
是	7(30.4)	50(34.5)	0.145	0.703
否	16(69.6)	95(65.5)
肿瘤位置
颈段、胸上段	7(30.4)	23(15.9)
胸中段	8(34.8)	51(35.2)	3.143	0.226
胸下段	8(34.8)	71(49.0)

References10

[1]	Prades J, Borras JM. Shifting sands: adapting the multidisciplinary team model to technological and organizational innovations in cancer care[J]. Future Oncol, 2014,10(13):1995-1998. DOI: 10.2217/fon.14.125. doi:10.2217/FON.14.125pmid:25396771
[2]	Taylor C, Shewbridge A, Harris J, et al. Benefits of multidisciplinary team work in the management of breast cancer[J]. Breast Cancer (Dove Med Press), 2013,30(5):79-85. DOI: 10.2147/BCTT.S35581.
[3]	苏向前, 邢加迪. 胃癌多学科综合治疗协作组诊疗模式专家共识[J]. 中国实用外科杂, 2017,37(1):37-38. DOI: 10.19538/j.cjps.issn1005-2208.2017.01.12.
[4]	Selby P, Popescu R, Lawler M, et al. The value and future developments of multidisciplinary team cancer care[J]. Am Soc Clin Oncol Educ Book, 2019,39:332-340. DOI: 10.1200/EDBK_236857. doi:10.1200/EDBK_236857pmid:31099640
[5]	中国医师协会神经外科医师分会脑胶质瘤专业委员会. 胶质瘤多学科诊治(MDT)中国专家共识[J]. 中华神经外科杂志, 2018,34(2):113-118. DOI: 10.3760/cma.j.issn.1001-2346.2018.02.002.
[6]	钱俊, 李德川, 朱远, 等. 大肠癌治疗模式变迁[J]. 中国肿瘤, 2013,22(12):966-969. DOI: 10.11735/j.issn.1004-0242.2013.12.A005.
[7]	Wright FC, De Vito C, Langer B, et al. Multidisciplinary cancer conferences: a systematic review and development of practice standards[J]. Eur J Cancer, 2007,43(6):1002-1010. DOI: 10.1016/j.ejca.2007.01.025. doi:10.1016/j.ejca.2007.01.025
[8]	European partnership action against cancer consensus group, Borras JM, Albreht T, et al. Policy statement on multidisciplinary cancer care[J]. Eur J Cancer, 2014,50(3):475-480. DOI: 10.1016/j.ejca.2013.11.012. doi:10.1016/j.ejca.2013.11.012
[9]	吴毓, 蒋旻珏, 贾慧珣, 等. 中国大陆部分医院癌症诊疗模式和临床分期使用情况的调查[J]. 中国癌症杂志, 2015,25(1):67-72. DOI: 10.3969/j.issn.1007-3969.2015.01.012.
[10]	Leidy SD, 陶红兵, 蔡苗, 等. 肿瘤多学科团队实施现状及影响因素研究[J]. 中国医疗管理科学, 2017,7(3):28-33. DOI: 10.3969/j.issn.2095-7432.2017.03.006.

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