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Outcomes and impact of multidisciplinary team care on immunologic and hemato-oncologic pediatric patients
Alicia Domínguez Estirado1, Gonzalo Solís García2, Jorge Huerta Aragonés2
1Immuno-Allergy Pediatrics Department, University Hospital Gregorio Marañón, Madrid, Spain.
Insights
A multidisciplinary team approach is effective for diagnosing and treating complex pediatric immunologic and hemato-oncologic disorders. This collaborative strategy significantly improves diagnostic accuracy in children with these challenging conditions.
Area of Science:
- Pediatric Immunology
- Pediatric Hematology-Oncology
- Multidisciplinary Care
Background:
- Pediatric immunologic and hemato-oncologic disorders present complex diagnostic and management challenges.
- Multidisciplinary teams are recognized as beneficial for addressing these complexities.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of a multidisciplinary approach for pediatric patients with immunologic and hemato-oncologic conditions.
- To analyze diagnostic outcomes and patient characteristics within a specialized multidisciplinary consultation.
Main Methods:
- Retrospective observational study of 93 pediatric patients at a tertiary referral center.
- Inclusion of patients from a multidisciplinary outpatient consultation involving pediatric oncohematologists and immunologists (April 2016 - December 2019).
- Collection and analysis of epidemiologic, clinical, and laboratory data, correlating age, gender, and visits with final diagnoses.
Main Results:
- Laboratory abnormalities were the primary referral reason (87.2%), with 78% having pre-existing comorbidities.
- Diagnostic yield increased significantly, with final diagnoses reached in 58.1% of patients post-multidisciplinary assessment, compared to 14% prior.
- No significant correlation found between final diagnosis and gender, age, or number of consultation visits.
Conclusions:
- A multidisciplinary approach is feasible and highly effective for diagnosing and treating pediatric immunologic, hematologic, and oncologic diseases.
- This collaborative model serves as a powerful tool, particularly for complex pediatric cases requiring specialized, integrated care.
Introduction:
Immunologic and hemato-oncologic disorders in the pediatric population represent an interrelated and complex group of conditions whose approach, diagnosis, and management could be difficult. Multidisciplinary teams have been proved beneficial in treating such complexities.
Methods:
We conducted a retrospective observational study at a tertiary hospital in Madrid, Spain, which is a pediatric immunology and onco-hematology referral center. We included all patients of multidisciplinary outpatient consultation, comprising a working group of pediatric oncohematologists and immunologists, between April 2016 and December 2019. Epidemiologic, clinical, and laboratory data were collected. We analyzed these data and established a relationship between age and findings of final diagnosis as well as variance on diagnoses prior to their multidisciplinary assessment and number of visits to the consultation.
Results:
In all, 93 children and adolescents were included in this study. Laboratory abnormalities were the most frequent reason for being referred to our unit (87.2%); 78% of children had a previously diagnosed comorbidity. Before starting follow-up in the multidisciplinary consultation, 14% of patients were diagnosed, and after the study by the multidisciplinary team, the final diagnosis was reached in 58.1% of patients. No correlation was discovered between final diagnosis and gender (P = 0.29), age (biserial correlation coefficient, r = 0.036, P = 0.70), and number of visits (P = 0.07).
Conclusion:
A multidisciplinary approach to immunologic, hematologic, and oncologic pediatric diseases is feasible. It can be a powerful and useful tool for diagnosis and treatment, especially in complex pediatric patients.
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