Multi-disciplinary team（MDT） is a best model to provide the optimal diagnosis and treatment strategy for difficult and complex diseases. It is of great significance to promote the MDT diagnosis and treatment mode for improving the quality of outpatient medical service. This paper briefly introduces the origin, concept and application of MDT at home and abroad, and puts forward the directions that should be paid attention to and solved according to the problems existing in China, including promoting MDT vigorously and creating a good MDT culture. At the same time, we should continue to improve the outpatient MDT management system, develop suitable management plan, management system, workflow, quality control system, performance evaluation system for the hospital, build multi-disciplinary network information platform and establish monitoring mechanisms.
Objective To explore the application of multi-disciplinary team (MDT) clinics in fetal developmental abnormalities. Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital, Sichuan University between December 2021 and November 2022. The situation of pregnant women and fetuses was summarized and analyzed. Results There were 19362 registered pregnant women, of which 1125 (5.8%) had abnormal fetal development. Among them, 272 (24.2%) received prenatal MDT clinics diagnosis and treatment. Fetal developmental abnormalities were mainly characterized by structural abnormalities (208 cases, 76.5%), with the top three being central nervous system abnormalities, circulatory system abnormalities, and multiple malformations. There were 202 pregnant women who continue to conceive, and 70 cases had undergone induced labor, with an induced labor rate of 25.7%. The top three main causes of induced abortion were multiple malformations, central nervous system abnormalities, and circulatory system abnormalities. After prenatal MDT clinics diagnosis and treatment, the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected. Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.
The outpatient multi-disciplinary team (MDT) model is an important measure to improve the quality of medical services and enhance patients’ medical experience. The Second Affiliated Hospital of Zhejiang University School of Medicine has explored three types of outpatient MDT models, namely specialized disease model, self-service model, and professor team model, in order to improve the accessibility and coverage of outpatient MDT. Through practice, it has been found that the implementation of multi-type outpatient MDT models can further leverage the advantages of MDT in society, hospitals, and patients. This article will share the experience of building multi-type outpatient multi-disciplinary team models mentioned above.
Objective To investigate the current status of multi-disciplinary team (MDT) in outpatient clinics of medical institutions in Sichuan, and to provide reference for further promoting the MDT model in outpatient clinics. Methods In November 2022, questionnaires were distributed to the outpatient management personnel of Sichuan Outpatient Management and Medical Quality Control Center from various medical institutions. The questionnaire included the basic information of the survey subjects and medical institutions, the current status of outpatient MDT work, the current status of operation and management, and the internal and external influencing factors of MDT development. Results A total of 106 questionnaires were received, of which 104 were valid. There were 70 hospitals that had provided outpatient MDT services, with a development rate of 67.31%, mainly concentrated in the past 5 years. A total of 60 hospitals (85.71%) had established MDT related systems, but only 14 hospitals (20.00%) had carried out relevant quality evaluation work. Among the 104 outpatient management personnel surveyed, 83.65% believed that the external factor affecting the development of outpatient MDT was the lack of correct understanding of MDT by patients, and 78.85% believed that the internal factor affecting the development of outpatient MDT was the low participation enthusiasm of departments and doctors. Conclusions The outpatient MDT in Sichuan is still in its early stages of development, and the outpatient MDT model has not yet been unified in terms of establishment standards, organizational methods, operational management, and fee standards. In the future, relevant departments and medical institutions still need to work together to promote its sustainable development.
ObjectiveTo investigate the clinical value of multidisclplinary team (MDT) in the application of non-small cell lung cancer (NSCLC). MethodsWe retrospectively analyzed the postoperative clinical data of 80 patients with NSCLC in the First Hospital of Lanzhou University between January 2014 and May 2018. There were 56 males, 24 females at age of 59±10 years. Forty five patients were performed lobectomy with conventional model, 35 patients were also performed lobectomy after MDT discussion. The clinical effect of the two groups was compared. ResultsCompared to conventional model, MDT can shorten operation time, intraoperative blood loss, postoperative chest drainage, catheterization time, complications, length of stay and hospital costs. But there was no significant difference in intraoperative transthoracotomy proportion, delayed wound healing and postoperative pulmonary leakage between the two groups. ConclusionThe efficacy of MDT in the surgical treatment of NSCLC is satisfactory. The MDT is valuable during operation, which reduces surgical trauma and accelerate patients’ recovery, and deserves the clinical promotion.
The misdiagnosis rate and mortality of mesenteric ischemia are high, but with the continuous updating of diagnosis and treatment techniques and treatment concepts in recent years, many patients can get timely and effective treatment. This article starts from the epidemiology, vascular anatomy, etiology, clinical manifestations and classification of mesenteric ischemia, and the progress of diagnosis and treatment under the multidisciplinary diagnosis and treatment mode, and details the research progress of mesenteric ischemia at home and abroad. This paper focuses on the significance of multidisciplinary diagnosis and treatment mode in the diagnosis and treatment of mesenteric ischemia, in order to strengthen the treatment consciousness of mesenteric ischemia and explore a more accurate and effective treatment system. The purpose of this study is to provide some reference for avoiding intestinal infarction and improving the survival rate of intestinal tract.
Portal hypertension caused by viral post hepatic liver cirrhosis has brought a heavy burden to medical treatment in China. In addition to liver transplantation, the treatments include drugs, endoscopy, intervention and surgery, but the effect is not satisfactory. At present, the consensus and guideline for portal hypertension often focuse on a single treatment, and there is an urgent need for reasonable, standardized and individualized treatment to minimize the risk of upper gastrointestinal bleeding and improve the long-term survival of patients, which should also be the ultimate goal of multi-disciplinary treatment (MDT) mode of portal hypertension. The MDT diagnosis and treatment method of portal hypertension needs to be obtained in combination with the general situation of patients (including liver function level, upper gastrointestinal bleeding risk, hypersplenism, etc.) and local medical advantages. For patients with acute upper gastrointestinal bleeding, the treatment with less trauma and good hemostatic effect should be selected as far as possible. Patients with previous bleeding history or bleeding cessation should improve the relevant evaluation as soon as possible and submit it to MDT for discussion and selection of the next appropriate treatment. Drugs and endoscopy can be used for high-risk groups of upper gastrointestinal bleeding. Whether surgical preventive treatment can benefit patients or not needs further large sample research support. Minimally invasive surgery is the development direction of surgical treatment. Combination of internal and external treatment may give full play to their respective advantages, reducing the risk of bleeding and improving long-term survival.