Patient psychosocial information and input from certain experts in multidisciplinary tumor boards (MTBs) helps teams to reach decisions about cancer care more easily, according to an article published in Annals of Surgical Oncology.
In many health care institutions, recommendations about how to proceed with care are formulated by MTBs, which are composed of surgeons, radiologists, pathologists, oncologists, and nurses. However, studies have suggested that biomedical information may dominate MTB discussions, leading to decisions that do not properly account for patient comorbidities or psychosocial factors.
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In a study led by Tayana Soukup, MSc, Imperial College London, UK, researchers evaluated the different elements of the decision process to see how each affected the MTB’s ability to reach a decision.
For their analysis, researchers formed their own MTBs and assessed their ability to reach a decision (yes or no) in 1045 patient cases by using the Metric for the Observation of Decision-making, a validated tool that allows for the evaluation of the available patient information (case history, radiological, pathological, psychosocial information, comorbidities, and patient views) and how different members of the MTB contributed to discussions based on their core specialties (surgeons, oncologists, radiologists, pathologists, and specialist cancer nurses).
After a multiple logistic regression analysis, researchers found that patients’ psychosocial information was in fact a significant predictor of the MTB’s ability to reach a decision (odds ratio [OR] 1.35), along with the inputs of surgeons (OR 1.62), radiologists (OR 1.48), pathologists (OR 1.23), and oncologists (OR 1.13).
They also found that patient comorbidity information (OR 0.83) and nursing inputs (OR 0.87) were significant predictors of decision-making, indicating that these values may be associated with more complex cases and need more detailed review.
From these results, researchers concluded that input from certain multidisciplinary health care professionals and patients’ psychosocial information may help to make decision-making easier while comorbidities and nursing inputs may make it more difficult. More research should be conducted to better define case complexity and determine ways to better integrate patient psychosocial information into decision making.
