Background:
Australian guidelines on the conduct of multidisciplinary cancer meetings
(MDMs) are largely based on expert opinion. Evidence-based guidelines on the
conduct of MDMs were developed based on a literature review and results of a
questionnaire survey administered to health professionals and patients across 5
Victorian centres. A Delphi study was performed to refine these guidelines and
ensure they are nationally relevant.
Methods: Opinion leaders in the fields of cancer care, health policy and ethics
were invited to join an expert panel. Two consecutive multiple-choice and short
answer questionnaires pertaining to each guideline were administered according
to Delphi methodology. A summary of the evidence relevant to each guideline
accompanied the questionnaire. Consensus regarding agreement was defined a
priori as 75% of respondents scoring > 7 (using a 9-point likert scale).
Results: 23 experts agreed to participate, 19 responses were received in round
1 (83% response rate). In round 2, 13 responses were received (57% RR). The
panel reached consensus on the following proposed guidelines: 1)Discussion at
MDM should result in an individualised, evidence based treatment plan agreed to
by consensus. 2)Where divergent views exist, each option should be discussed
with the patient. 3)The treatment plan should be documented in the medical
record using a proforma and disseminated to treating clinicians outside the
institution. 4)Documentation should be detailed enough to discuss and institute
the MDM teams’ treatment plan 5) patients should be informed of the MDM process
but do not need to provide informed consent. Consensus was not achieved regarding
the role of MDMs in addressing the supportive care needs of patients.
Conclusions: These are the first Australian guidelines based on empirical
evidence informing the conduct of MDMs. Innovative strategies need to be
developed to facilitate the integration of the supportive care needs of
patients into treatment planning within MDMs.