Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Surgical risk calculators are not often routinely used in Urology Multidisciplinary Meetings (MDM), and little is known about their impact on clinical decision-making. The aim of this study is to assess the utility of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) risk calculator for decision-making in the Urology MDM setting, with particular consideration given to decisions about surgical candidacy. METHODS: We analysed all adult patients discussed in our Urology MDM with urological conditions whose management plan could potentially include major surgery. During a MDM, a consensus management decision was made prior to the NSQIP score being revealed to blinded team members. Any change in decision after revealing the score was documented, including rationale. RESULTS: Sixty-three out of 64 eligible cancer cases being discussed at MDM warranted NSQIP scores being revealed to the MDM post initial consensus. 95.2% (n = 60) did not have a change in the MDM management plan after reveal of NSQIP score. The NSQIP score led to a change in the MDM management decision in three cases: two renal cancer cases where management changed to biopsy with view to microwave ablation if positive, and one prostate cancer case, where management changed to recommend against radical prostatectomy. CONCLUSION: The NSQIP risk calculator was a useful tool and adjunct in the MDM setting. It served as a safety net where surgical risk was not initially properly estimated by team members, and reinforced decisions where there was concordance between NSQIP score and clinical judgement.
Source: ANZ Journal of Surgery
DOI: 10.1111/ans.19357
Institutions: The University of Melbourne, Northern Health
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,730
OpenAlex ID: W4405372646