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PLoS One. 2015 Oct 6;10(10):e0139921. doi: 10.1371/journal.pone.0139921. eCollection 2015.

In Absentia: An Exploratory Study of How Patients Are Considered in Multidisciplinary Cancer Team Meetings.

Author information

1
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
2
Gordon and Betty Moore Foundation, Palo Alto, California, United States of America; Department of Medicine, University of California Los Angeles, Los Angeles, California, United States of America.
3
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, United States of America.

Abstract

BACKGROUND:

Multidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This study aimed to investigate how decisions are made in multidisciplinary team meetings and whether patient perspectives are incorporated in these decisions.

MATERIALS AND METHODS:

A qualitative study was conducted using non-participant observation at multidisciplinary team meetings (also called tumor boards) at the University Cancer Center Hamburg-Eppendorf, Germany. Two researchers recorded structured field notes from a total of N = 15 multidisciplinary team meetings. Data were analyzed using content analysis and descriptive statistics.

RESULTS:

Physicians mainly exchanged medical information and based their decision-making on this information. Individual patient characteristics or their treatment preferences were rarely considered or discussed. In the few cases where patient preferences were raised as a topic, this information did not seem to be taken into account in decision-making processes about treatment recommendations.

CONCLUSION:

The processes in multidisciplinary team meetings we observed did not exhibit shared decision-making. Patient perspectives were absent. If multidisciplinary team meetings wish to become more patient-centred they will have to modify their processes and find a way to include patient preferences into the decision-making process.

PMID:
26441328
PMCID:
PMC4595280
DOI:
10.1371/journal.pone.0139921
[Indexed for MEDLINE]
Free PMC Article

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