Intended for healthcare professionals

Rapid response to:

Analysis

Multidisciplinary team working in cancer: what is the evidence?

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c951 (Published 23 March 2010) Cite this as: BMJ 2010;340:c951

Rapid Response:

Vital role of MDTs in data collection for population health improvement

We would like to raise the critical potential role that MDTs can play
in evaluating performance for cancer patient populations by collecting
accurate staging data at source and in a more timely manner than currently
occurs with routine cancer registration.

Whilst there may be a lack of formal evidence regarding cost benefits
of clinical decision-making via MDTs, it should also be noted that the
Cancer Reform Strategy identifies the MDT meeting as an important vehicle
for collection and validation of clinical cancer data items. In
particular, this refers to co-morbidities, performance status and stage of
disease. We would, therefore, like to raise the critical role that MDTs
can also play in evaluating performance for cancer patient populations by
collecting accurate staging data at source and in a more timely manner
than currently occurs with routine cancer registration.

The problems we experience with collecting MDT staging data is that
there are a multitude of different and ad hoc data collection systems
currently in operation across hospitals and cancer MDTs - some still paper
based, some on bespoke locally developed spreadsheets - with only a few
apparently that are linked into Trusts' main Patient Administration
Systems. Thankfully this is being addressed, albeit slowly, through a
number of initiatives (various Cancer Network informatics procurement
strategies, Cancer Minimum Dataset etc). The requirement for Trusts as
part of NHS core contract to deliver data electronically to cancer
registries by the end of March 2011 is also key, although our experience
suggests that meeting this target will be a challenge for Trusts.

There is increasing evidence that earlier diagnosis improves cancer
outcomes1. If we can get accurate staging data at time of diagnosis (or
soon after) then it allows us to have real debates about the true impact
of delay on survival, and to monitor the impact of interventions to
improve earlier diagnosis. MDTs therefore play a significant role in
improving the health of the population.

1 M A Richards. The National Awareness and Early Diagnosis Initiative
in England: assembling the evidence. Br J Cancer. 2009 December 3;
101(S2): S1–S4. Published online 2009 December 3. doi:
10.1038/sj.bjc.6605382.

Competing interests:
None declared

Competing interests: No competing interests

04 April 2010
Fiona Day
Consultant in Public Health
Colin Pollock, Caroline Brook, and Alex Albus
NHS Yorkshire and the Humber