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

Pola Hahlweg, Jana Hoffmann, Martin Härter, Dominick L Frosch, Glyn Elwyn, Isabelle Scholl, Pola Hahlweg, Jana Hoffmann, Martin Härter, Dominick L Frosch, Glyn Elwyn, Isabelle Scholl

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.

Conflict of interest statement

Competing Interests: The authors of this manuscript have the following competing interests: Glyn Elwyn initiated and developed the Option Grid Collaborative, which produces tools to support shared decision making. He is part of a research team that has developed the CollaboRATE, a patient reported measure of shared decision making. He acts as an adviser to Emmi Solutions, a producer of patient decision support interventions in the US. There are no other financial disclosures or conflicts of interest for any of the authors. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

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