通过数字化多学科团队管理优化原发不明癌症患者的诊断途径:回顾性分析。

IF 3.4 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
J R J Willems, M J Lahaye, P Snaebjornsson, S Marchetti, M A Vollebergh, L W van Golen, W V Vogel, Z J Cheung, S Rostami, Z Bodalal, R G H Beets-Tan, D M J Lambregts
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引用次数: 0

摘要

目的:未知原发癌(CUP)的诊断途径往往不发达。在我们的CUP三级转诊中心,我们最近引入了一种新的诊断工作流程,其中包括由专门的多学科团队(MDT)对CUP患者进行数字化讨论,集中的第二意见审查,以及MDT指导的进一步诊断步骤。本研究回顾性地评估了优化后的工作流程在效率、诊断率和医疗保健专业人员满意度方面的结果。方法:我们回顾性比较了39例A期患者(2021年5月至2022年4月)和41例B期患者(2022年12月至2023年11月)在工作流程优化后的结果。结果包括诊断时间、诊断率、第二意见影像学评价的影响以及MDT成员的满意度。结果:实施工作流程后,诊断/治疗的中位时间从36天减少到28天(p = 0.07)。第二意见影像学检查导致10%的病例发现新的肿瘤病变。A期49%的患者确诊为原发性肿瘤,B期为61% (p = 0.37)。MDT成员的满意度显著提高,特别是在跨学科沟通和工作流程效率方面。结论:我们优化的CUP工作流程,包括数字化mdt讨论和常规的影像和病理数据第二意见审查,提高了诊断效率和医生的满意度。这些结果突出了多学科的价值,以患者为中心的方法侧重于有效的CUP患者管理。知识进步:在CUP护理中整合数字化MDT讨论和集中的第二意见审查可以提高诊断效率,并可能提高原发性肿瘤的检出率。放射科医生和其他诊断医师在这种多学科方法中发挥着关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimising Diagnostic Pathways through digital Multidisciplinary Team management of Patients with Cancer of Unknown Primary: a Retrospective Analysis.

Objectives: Diagnostic pathways for cancer of unknown primary (CUP) are often underdeveloped. At our tertiary referral centre for CUP, we recently introduced a new diagnostic workflow that includes digital discussion of CUP patients by a dedicated multidisciplinary team (MDT), centralised second opinion reviews, and an MDT-guided approach to further diagnostic steps. This study retrospectively assesses the outcomes of this optimised workflow on efficiency, diagnostic yield, and healthcare professional satisfaction.

Methods: We retrospectively compared outcomes for 39 patients from period A(May 2021-April 2022) to 41 patients from period B(Dec 2022-Nov 2023) following workflow optimisation. Outcomes included time-to-diagnosis, diagnostic yield, impact of second opinion imaging reviews, and satisfaction levels among involved MDT members.

Results: After workflow implementation, median time to diagnosis/treatment decreased from 36 to 28 days(p = 0.07). Second opinion imaging reviews led to the detection of new tumour lesions in 10% of cases. A primary tumour diagnosis was established 49% patients from period A versus 61% in period B(p = 0.37). Satisfaction among MDT members notably improved, especially regarding interdisciplinary communication and workflow efficiency.

Conclusion: Our optimised CUP workflow with digital MDT-discussions and routine second opinion reviews of imaging and pathology data, improved diagnostic efficiency and satisfaction among physicians. These results highlight the value of a multidisciplinary, patient-centred approach focused on effective patient management in CUP.

Advances in knowledge: Integrating digital MDT discussions and centralized second-opinion reviews in CUP care improves diagnostic efficiency and may enhance primary tumour detection rates. Radiologists and other diagnosticians play a key role in this multidisciplinary approach.

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来源期刊
British Journal of Radiology
British Journal of Radiology 医学-核医学
CiteScore
5.30
自引率
3.80%
发文量
330
审稿时长
2-4 weeks
期刊介绍: BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences. Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option
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