Imperial College London
Alternate

ProfessorNickSevdalis

Faculty of Medicine, Department of Surgery & Cancer

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 7594 3431n.sevdalis Website

 
 
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Location

 

507, Wright Fleming BNorfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Soukup:2016:10.1097/MD.0000000000003885,
author = {Soukup, Ascencao T and Petrides, VK and Lamb, BW and Sarkar, S and Arora, S and Darzi, A and Green, JSA and Sevdalis, N},
doi = {10.1097/MD.0000000000003885},
journal = {Medicine},
title = {The anatomy of clinical decision-making in multidisciplinary cancer meetings: a cross-sectional observational study of teams in a natural context},
url = {http://dx.doi.org/10.1097/MD.0000000000003885},
volume = {95},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Abstract: In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable.The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision.This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons.We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis.The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = -0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001).Hawthorne effect is the main limitation of the study.The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient prof
AU  - Soukup,Ascencao T
AU  - Petrides,VK
AU  - Lamb,BW
AU  - Sarkar,S
AU  - Arora,S
AU  - Darzi,A
AU  - Green,JSA
AU  - Sevdalis,N
DO  - 10.1097/MD.0000000000003885
PY  - 2016///
SN  - 0025-7974
TI  - The anatomy of clinical decision-making in multidisciplinary cancer meetings: a cross-sectional observational study of teams in a natural context
T2  - Medicine
UR  - http://dx.doi.org/10.1097/MD.0000000000003885
UR  - http://hdl.handle.net/10044/1/32815
VL  - 95
ER  -
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