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Lower MeDiC score is associated with non-referral to multidisciplinary team meeting discussion in bladder cancer patients : a nationwide and population-based study

Wihl, Jessica LU ; Hagberg, Oskar LU ; Aljabery, Firas ; Gårdmark, Truls ; Hosseini, Abolfazl ; Jahnson, Staffan ; Jerl-Ström, Tomas ; Ströck, Viveka ; Söderkvist, Karin and Ullén, Anders , et al. (2025) In Acta Oncologica 64. p.616-622
Abstract

Background and purpose: The Measure of Case-Discussion Complexity (MeDiC) tool was created to gauge case complexity at multidisciplinary team meetings (MDTM) for case selection and prioritization. We aimed to assess applicability and association with MeDiC score and non-compliance with national guide-line-recommendations for MDTM referral in a bladder cancer setting. Material and methods: A modified MeDiC scoring system was applied in 8955 subjects with localized (T1-T4N0M0) or metastasized disease as per the Bladder Cancer Data Base Sweden (BladderBaSe) 2.0. Association between MeDiC score and not being discussed at MDTM was investigated by multivariable logistic regression, and further explored in relation to calendar time period,... (More)

Background and purpose: The Measure of Case-Discussion Complexity (MeDiC) tool was created to gauge case complexity at multidisciplinary team meetings (MDTM) for case selection and prioritization. We aimed to assess applicability and association with MeDiC score and non-compliance with national guide-line-recommendations for MDTM referral in a bladder cancer setting. Material and methods: A modified MeDiC scoring system was applied in 8955 subjects with localized (T1-T4N0M0) or metastasized disease as per the Bladder Cancer Data Base Sweden (BladderBaSe) 2.0. Association between MeDiC score and not being discussed at MDTM was investigated by multivariable logistic regression, and further explored in relation to calendar time period, healthcare region, age at diagnosis and hospital volume. Results and interpretation: Median total MeDiC score was lower in individuals not being discussed at an MDTM (7.0 Inter Quartile Range [IQR] 6.0–9.0) compared to those who were (8.0 IQR 6.0–10.0). Adjusted odds ratio for not being discussed at an MDTM was 2.1 (95% confidence interval [CI] 1.8–2.4) for a MeDiC score in the lower quartile, as compared to the highest quartile, with higher estimates when perform-ing stratified analyses in later calendar years and in specific healthcare regions. Our data indicate that the MeDiC score is applicable in bladder cancer patients, and we identified an association between lower MeDiC score and not being discussed at an MDTM.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, complexity factors, guidelines, multidisciplinary team meeting, scoring system, treatment recommendation
in
Acta Oncologica
volume
64
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • pmid:40325792
  • scopus:105004710040
ISSN
0284-186X
DOI
10.2340/1651-226X.2025.42756
language
English
LU publication?
yes
id
935fc85c-2536-4bc0-be54-3d604610a0de
date added to LUP
2025-09-24 14:32:57
date last changed
2025-10-14 11:59:39
@article{935fc85c-2536-4bc0-be54-3d604610a0de,
  abstract     = {{<p>Background and purpose: The Measure of Case-Discussion Complexity (MeDiC) tool was created to gauge case complexity at multidisciplinary team meetings (MDTM) for case selection and prioritization. We aimed to assess applicability and association with MeDiC score and non-compliance with national guide-line-recommendations for MDTM referral in a bladder cancer setting. Material and methods: A modified MeDiC scoring system was applied in 8955 subjects with localized (T1-T4N0M0) or metastasized disease as per the Bladder Cancer Data Base Sweden (BladderBaSe) 2.0. Association between MeDiC score and not being discussed at MDTM was investigated by multivariable logistic regression, and further explored in relation to calendar time period, healthcare region, age at diagnosis and hospital volume. Results and interpretation: Median total MeDiC score was lower in individuals not being discussed at an MDTM (7.0 Inter Quartile Range [IQR] 6.0–9.0) compared to those who were (8.0 IQR 6.0–10.0). Adjusted odds ratio for not being discussed at an MDTM was 2.1 (95% confidence interval [CI] 1.8–2.4) for a MeDiC score in the lower quartile, as compared to the highest quartile, with higher estimates when perform-ing stratified analyses in later calendar years and in specific healthcare regions. Our data indicate that the MeDiC score is applicable in bladder cancer patients, and we identified an association between lower MeDiC score and not being discussed at an MDTM.</p>}},
  author       = {{Wihl, Jessica and Hagberg, Oskar and Aljabery, Firas and Gårdmark, Truls and Hosseini, Abolfazl and Jahnson, Staffan and Jerl-Ström, Tomas and Ströck, Viveka and Söderkvist, Karin and Ullén, Anders and Holmberg, Lars and Häggström, Christel and Liedberg, Fredrik}},
  issn         = {{0284-186X}},
  keywords     = {{Bladder cancer; complexity factors; guidelines; multidisciplinary team meeting; scoring system; treatment recommendation}},
  language     = {{eng}},
  pages        = {{616--622}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{Lower MeDiC score is associated with non-referral to multidisciplinary team meeting discussion in bladder cancer patients : a nationwide and population-based study}},
  url          = {{http://dx.doi.org/10.2340/1651-226X.2025.42756}},
  doi          = {{10.2340/1651-226X.2025.42756}},
  volume       = {{64}},
  year         = {{2025}},
}