Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality
Abstract Introduction This study aimed to evaluate the consistency of lung cancer case assessments across multidisciplinary team (MDT) sites in Denmark. The goal was to appraise the comparability of outcomes between hospitals in a real-world context. Methods We prepared sixty comprehensive, fictitio...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-11-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-024-13188-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846158493081403392 |
|---|---|
| author | Torben Riis Rasmussen Anja Gouliaev Erik Jakobsen Karin Hjorthaug Lene Unmack Larsen Peter Meldgaard Jesper Thygesen Rana Bibi Lars B. Møller Arman Arshad Birgitte Folkersen Anette Højsgaard Zaigham Saghir Klaus R. Larsen Jesper Ravn |
| author_facet | Torben Riis Rasmussen Anja Gouliaev Erik Jakobsen Karin Hjorthaug Lene Unmack Larsen Peter Meldgaard Jesper Thygesen Rana Bibi Lars B. Møller Arman Arshad Birgitte Folkersen Anette Højsgaard Zaigham Saghir Klaus R. Larsen Jesper Ravn |
| author_sort | Torben Riis Rasmussen |
| collection | DOAJ |
| description | Abstract Introduction This study aimed to evaluate the consistency of lung cancer case assessments across multidisciplinary team (MDT) sites in Denmark. The goal was to appraise the comparability of outcomes between hospitals in a real-world context. Methods We prepared sixty comprehensive, fictitious lung cancer case stories, complete with images, and distributed them to the four primary lung cancer MDT conferences in Denmark. These cases were subsequently evaluated as had they been ordinary patients during regular MDT meetings. We compared the conclusions on assigned TNM stage and proposed treatment intent using Kappa statistics. Results The consensus on assigned stage (Stages IA-B, IIA-B, IIIA-B, IV, and undetermined) corresponded to a Fleiss’ Kappa-value of 0.62 (95% CI: 0.52–0.71). The overall assessment of curability, categorized as Curable, Incurable, and Undetermined, corresponded to a Kappa-value of 0.72 (CI: 0.61–0.84). However, for cases unanimously judged by all MDT sites to be Stage III, the concordance on treatment intent was poor, with an agreement coefficient of only 0.32 (95% CI: -0.27–0.97). Conclusion In detail, the level of agreement on assigned stages was less than desired. In consequence, comparative analyses of treatment results from different hospitals or centres may be prone to bias caused by systematic differences in stage assessment or intent of treatment. The least consensus was observed for cases in Stage III, indicating a need for quality improvement efforts to ensure a higher degree of consistency in MDT decisions. |
| format | Article |
| id | doaj-art-f0da2178d14641f49b9f1ff78418e02d |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-f0da2178d14641f49b9f1ff78418e02d2024-11-24T12:30:02ZengBMCBMC Cancer1471-24072024-11-0124111110.1186/s12885-024-13188-4Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equalityTorben Riis Rasmussen0Anja Gouliaev1Erik Jakobsen2Karin Hjorthaug3Lene Unmack Larsen4Peter Meldgaard5Jesper Thygesen6Rana Bibi7Lars B. Møller8Arman Arshad9Birgitte Folkersen10Anette Højsgaard11Zaigham Saghir12Klaus R. Larsen13Jesper Ravn14Department of Respiratory Diseases and Allergy, Aarhus University Hospital (AUH)Department of Respiratory Diseases and Allergy, Aarhus University Hospital (AUH)Department of Thoracic Surgery, Odense University Hospital (OUH)Department of Nuclear Medicine, AUHDepartment of X-ray & Scanning, AUHCancer Department, AUHDepartment of Clinical Engineering, AUHDepartment of Pulmonary Diseases, Aalborg University HospitalDepartment of Thoracic Surgery, Aalborg University HospitalDepartment of Pulmonary Diseases, OUHDepartment of Respiratory Diseases and Allergy, Aarhus University Hospital (AUH)Department of Thoracic Surgery, AUHPulmonary Diseases Section, Medical Department, Gentofte HospitalDepartment of Pulmonary Infections & Medicine, Bispebjerg HospitalDepartment of Thoracic Surgery, RigshospitaletAbstract Introduction This study aimed to evaluate the consistency of lung cancer case assessments across multidisciplinary team (MDT) sites in Denmark. The goal was to appraise the comparability of outcomes between hospitals in a real-world context. Methods We prepared sixty comprehensive, fictitious lung cancer case stories, complete with images, and distributed them to the four primary lung cancer MDT conferences in Denmark. These cases were subsequently evaluated as had they been ordinary patients during regular MDT meetings. We compared the conclusions on assigned TNM stage and proposed treatment intent using Kappa statistics. Results The consensus on assigned stage (Stages IA-B, IIA-B, IIIA-B, IV, and undetermined) corresponded to a Fleiss’ Kappa-value of 0.62 (95% CI: 0.52–0.71). The overall assessment of curability, categorized as Curable, Incurable, and Undetermined, corresponded to a Kappa-value of 0.72 (CI: 0.61–0.84). However, for cases unanimously judged by all MDT sites to be Stage III, the concordance on treatment intent was poor, with an agreement coefficient of only 0.32 (95% CI: -0.27–0.97). Conclusion In detail, the level of agreement on assigned stages was less than desired. In consequence, comparative analyses of treatment results from different hospitals or centres may be prone to bias caused by systematic differences in stage assessment or intent of treatment. The least consensus was observed for cases in Stage III, indicating a need for quality improvement efforts to ensure a higher degree of consistency in MDT decisions.https://doi.org/10.1186/s12885-024-13188-4Multidisciplinary team meetingMDTLung cancerReal world setting |
| spellingShingle | Torben Riis Rasmussen Anja Gouliaev Erik Jakobsen Karin Hjorthaug Lene Unmack Larsen Peter Meldgaard Jesper Thygesen Rana Bibi Lars B. Møller Arman Arshad Birgitte Folkersen Anette Højsgaard Zaigham Saghir Klaus R. Larsen Jesper Ravn Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality BMC Cancer Multidisciplinary team meeting MDT Lung cancer Real world setting |
| title | Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality |
| title_full | Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality |
| title_fullStr | Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality |
| title_full_unstemmed | Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality |
| title_short | Impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality |
| title_sort | impact of multidisciplinary team discrepancies on comparative lung cancer outcome analyses and treatment equality |
| topic | Multidisciplinary team meeting MDT Lung cancer Real world setting |
| url | https://doi.org/10.1186/s12885-024-13188-4 |
| work_keys_str_mv | AT torbenriisrasmussen impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT anjagouliaev impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT erikjakobsen impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT karinhjorthaug impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT leneunmacklarsen impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT petermeldgaard impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT jesperthygesen impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT ranabibi impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT larsbmøller impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT armanarshad impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT birgittefolkersen impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT anettehøjsgaard impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT zaighamsaghir impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT klausrlarsen impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality AT jesperravn impactofmultidisciplinaryteamdiscrepanciesoncomparativelungcanceroutcomeanalysesandtreatmentequality |