What is the role of the multidisciplinary team meeting in primary prolapse surgery and are alternative formats acceptable?

Abstract

Introduction and hypothesisIn 2019, the UK National Institute for Health and Care Excellence (NICE) recommended discussion of all primary prolapse cases at a multidisciplinary team (MDT) meeting prior to surgery. However, following the COVID-19 pandemic, face-to-face meetings were suspended. The aim of this study was to evaluate the role of MDT meetings in an observational retrospective review of primary prolapse cases and determine whether alternatives to face-to-face MDT meetings such as virtual and remote paper result in different outcomes. Methods A total of 100 consecutive patients with primary prolapse, who had already been through face-to-face MDT meetings in 2019, were subjected to remote paper (independent review by team members, who then submit a paper outcome to the MDT meeting chair) and a virtual MDT meeting by the same team (blinded). Outcomes included agree, minor amendment (changing the order of priority of the compartment, changing procedure from + to +/−), major amendment (adding/removing a compartment) and insufficient information. MDT outcomes were compared for remote paper, virtual, and face-to-face MDT options. Results In 88% of cases, face-to-face MDT meetings agreed to proceed unchanged (4% minor amendment, 7% major amendment, 1% insufficient information). This compared with 80% at virtual MDT (5% minor amendment, 11% major amendment, 4% insufficient information) and 74% when conducted by remote paper (5% minor amendment, 15% major amendment, 6% insufficient information). There was no significant difference in outcomes among the MDT meeting formats (Chi-squared 7.73, p=0.26). Conclusions Multidisciplinary team discussion changes management in a minority of primary prolapse cases. Similar MDT decisions are produced by virtual and remote paper formats, although the latter had the lowest concordance of opinions.

Application of Multidisciplinary Diagnosis and Treatment (MDT) Clinical Teaching Model in the Clinical Teaching of Some Undergraduates of Breast Diseases in Surgery

“…The second is eclecticism, which is conducive to the formation of integrated thinking. In the process of diagnosis and treatment of speci c cases, teachers of different disciplines have different emphases, and the special products and techniques mastered by students are also diverse 19 . From the intuitive status of the disease to the inquiry and collection of medical history information, from the application of tumor markers to reference image data, from the collection of pathological data to the formation of the entire treatment plan, it is integrated.…”