PDF(Pubmed)
Abstract：
Introduction The urology multidisciplinary team meeting (MDT) is the key weekly meeting that allows the opportunity to review results and discuss management plans for all urological cancers within a department. As populations age and cancer detection and management improve, the demand for the MDT will increase. We conducted a collaborative transregional study within the UK to evaluate the current workload on the urology MDT. Methods The study was divided into two parts: a multicenter retrospective audit and a snapshot survey. Three UK hospitals in Birmingham, Liverpool, and Cardiff were recruited into the multicenter study. Each hospital provided full MDT lists for all weekly meetings between August 2017 and 2022. Retrospective data gathered included the number of patients discussed per week, the average age of patients per week, the time allocated to their weekly MDT, and the total number of consultants in the department. The second part of the study involved the distribution of an online questionnaire to urologists across the UK to obtain a snapshot picture with the above parameters. Results Snapshot data from 34 different UK hospitals showed MDT length ranged from 1-6 hours, patients discussed ranged from 10-90 per week, and the maximum average discussion time was 3.8 minutes per case. Furthermore, 76% (N = 28/37) of respondents said unnecessary cases were discussed. Varied suggestions were provided on how the MDT could be improved. Multicenter five-year data showed a rise in mean total numbers of patients discussed per week in all centers: a 34.8% increase in Birmingham (from 34.5 patients to 46.5 patients), a 23.5% increase in Liverpool (27.2 patients to 33.6 patients), and a 38.8% increase in Cardiff (22.7 patients to 31.5 patients). Hours per meeting were Birmingham (2), Liverpool (3), and Cardiff (4), which meant the average minutes per patient discussion were Birmingham (2.6), Liverpool (5.4), and Cardiff (7.6). Conclusion There is a rapidly rising trend across UK regions for the number of patients being discussed in the urology MDT meeting. The MDT structure and function across the country are highly variable. There is consensus that the MDT discusses cases that are unnecessary, and this has been recognized for many years. Widespread implementation of the latest MDT management guidelines is urgently required to ensure MDT meetings are able to function effectively and efficiently into the future.
摘要：
介绍泌尿科多学科小组会议（MDT）是关键的每周会议，使您有机会审查结果并讨论部门内所有泌尿科癌症的管理计划。随着人口老龄化和癌症检测和管理的改善，对MDT的需求将会增加。我们在英国进行了一项跨区域合作研究，以评估泌尿科MDT的当前工作负荷。方法本研究分为多中心回顾性审计和快照调查两部分。伯明翰的三家英国医院，利物浦,和加的夫被纳入多中心研究。每家医院都为2017年8月至2022年的所有每周会议提供了完整的MDT清单。收集的回顾性数据包括每周讨论的患者数量，患者每周的平均年龄，分配给他们每周MDT的时间，以及该部门的顾问总数。研究的第二部分涉及向英国各地的泌尿科医生分发在线问卷，以获得具有上述参数的快照图片。结果来自英国34家不同医院的快照数据显示MDT长度为1-6小时，讨论的患者范围为每周10-90，最大平均讨论时间为3.8分钟/例。此外，76%(N=28/37)的受访者表示讨论了不必要的案例。关于如何改进MDT提供了各种建议。多中心五年数据显示，所有中心每周讨论的患者平均总数均有所增加：伯明翰增加了34.8％（从34.5名患者增加到46.5名患者），利物浦患者增加了23.5%（27.2名患者增加到33.6名患者），加的夫患者增加38.8%（22.7例，31.5例）。每次会议的时间是伯明翰（2），利物浦（3）加的夫（4）这意味着每个患者讨论的平均分钟为伯明翰（2.6），利物浦（5.4），加的夫（7.6）。结论在泌尿外科MDT会议上讨论的患者数量在整个英国地区呈快速增长趋势。全国的MDT结构和功能变化很大。人们一致认为，MDT讨论了不必要的情况，这一点已经得到了多年的认可。迫切需要广泛实施最新的MDT管理准则，以确保MDT会议能够在未来有效地运作。
