Analysis of time taken to discuss new patients with head and neck cancer in multidisciplinary team meetings

BJ Mullan, JS Brown, D Lowe, Simon Rogers, RJ Shaw

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. A total of 105 patients with a new diagnosis of head and neck malignancy or complex benign tumour were discussed at 10 head and neck cancer MDT meetings. A single observer timed each discussion using a stopwatch, and recorded the number of discussants and the diagnosis and characteristics of each patient. Timings ranged from 15 to 480s (8min) with a mean of 119s (2min), and the duration of discussion correlated closely with the number of discussants (rs=0.63, p<0.001). The longest discussions concerned patients with advanced T stage (p=0.006) and advanced N stage (p=0.009) disease, the elderly (p=0.02) and male patients (p=0.05). Tumour site and histological findings were not significant factors in the duration of discussion. Most discussions on patients with early stage tumours were short (T1: 58% less than 60s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence.
    Original languageEnglish
    Pages (from-to)128-133
    Number of pages6
    JournalBritish Journal of Oral and Maxillofacial Surgery
    Volume52
    Issue number2
    Early online date23 Nov 2013
    DOIs
    Publication statusPublished - Feb 2014

    Keywords

    • Discussion length
    • Head and neck cancer
    • MDT
    • Multidisciplinary team

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