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Improving patient outcomes through multidisciplinary treatment planning conference
Author(s) -
Lewis Carol M.,
Nurgalieva Zhannat,
Sturgis Erich M.,
Lai Stephen Y.,
Weber Randal S.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24325
Subject(s) - guideline , medicine , multidisciplinary approach , hazard ratio , confidence interval , psychological intervention , intensive care medicine , emergency medicine , nursing , pathology , social science , sociology
Background The purpose of this study was for us to determine National Comprehensive Cancer Network (NCCN) guideline‐compliance of multidisciplinary conference (MDC) recommendations and actual treatment received, and to determine this impact on patient outcomes. Methods We conducted a retrospective review of patients presented at MDC between January 1, 2006, and December 31, 2006, with previously untreated incident cancers. Results We identified 232 patients, for whom MDC recommendations were NCCN guideline‐compliant in 201 (86.6%). Actual treatment was NCCN guideline‐compliant in 170 of 197 patients (86.3%). Adherence of MDC recommendations to NCCN guidelines was associated with superior overall survival (hazard ratio [HR] = 0.69; 95% confidence interval [CI] = 0.33–1.39; p = .3), as was guideline‐compliance of actual treatment (HR = 0.6; 95% CI = 0.64–1.07; p = .07); congruence between MDC recommendations and actual treatment conferred a statistically significant overall survival benefit (HR = 0.49; 95% CI = 0.27–0.89; p = .02). Conclusion Our findings argue for patient‐centered application of NCCN guidelines. Prospective evaluation will enable more timely identification of systematic NCCN guideline deviations that quality improvement interventions may address. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E1820–E1825, 2016