Abstract
Objective
To investigate decision making for patients with advanced ovarian cancer as a possible
explanation of geographical variation in treatment patterns.
Methods
We carried out a multi-centre observational study in multidisciplinary teams meetings
for five major UK cancer centres. All patients presenting to five cancer centres with
advanced ovarian cancer over a six-week period. The GO-MDT-MODe tool was used to provide
a measure of participation and quality of case discussion for all cases of advanced
ovarian cancer. MDT scores were correlated with surgical data extracted from national
audit data. Data were recorded for overall MDT performance.
Results
A total of 870 case discussions, including 145 cases of advanced ovarian cancer, were
observed. MDTs varied in structure, format and time allocation between centres. Cluster
analysis showed significant variation in quality and participation of discussion between
centres (p < 0.0025) and this correlated with the proportion of patients in the wider
cancer alliance undergoing surgery.
Conclusions
We have shown that at least part of the variation in practice seen in the UK correlates
with different behaviours within MDTs. Increasing time for discussion and encouraging
participation from all staff groups may increase proportions of patients undergoing
optimal treatment regimens.
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Article info
Publication history
Published online: March 15, 2023
Accepted:
March 11,
2023
Received in revised form:
February 27,
2023
Received:
December 12,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
