Multidisciplinary decision-making in older patients with cancer, does it differ from younger patients?

Area of Science:

• Oncology
• Health Services Research
• Geriatric Medicine

Background:

• Tailoring cancer treatment requires considering patient context and preferences, particularly for older adults.
• Assessing information quality in oncological multidisciplinary team (MDT) decision-making is crucial for patient-centered care.
• Comparison of information quality for older (≥70 years) versus younger patients in MDTs was investigated.

Purpose of the Study:

• To evaluate the quality of information used in oncological MDTs.
• To compare information quality between older and younger patient groups within MDTs.
• To identify disparities in patient-centered information during cancer treatment decisions.

Main Methods:

• Cross-sectional observations of oncological MDTs were conducted at a University Hospital.
• An observation tool was utilized to assess the quality of information input.
• Primary outcomes focused on information quality for older and younger patients; secondary outcomes included team member contributions, discussion duration, and decision formulation.

Main Results:

• 503 cases were observed; 32% of patients were ≥70 years old.
• Patient-centered information quality (psychosocial, patient's view) was poor for both age groups.
• No significant differences in information quality were found between age groups, except for better comorbidity information in older patients. Team contributions, discussion time (median 3.54 min), and decision rates (87.5%) were similar.

Conclusions:

• A consistent lack of patient-centered information was observed in oncological MDTs for all age groups.
• Comorbidity information was the only area showing a difference, favoring older patients.
• Cancer treatment decisions in MDTs were predominantly based on medical-technical information, indicating a need to integrate patient preferences more effectively.