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

Authors

  • Jessica Wihl Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden; Regional Cancer Centre South, Region Skåne, Lund, Sweden; Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden https://orcid.org/0000-0002-6708-3563
  • Oskar Hagberg Department of Translational Medicine, Lund University, Malmö, Sweden
  • Firas Aljabery Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
  • Truls Gårdmark Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
  • Abolfazl Hosseini Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  • Staffan Jahnson Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
  • Tomas Jerlström Department of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  • Viveka Ströck Department of Urology, Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
  • Karin Söderkvist Department of Diagnostics and Intervention, Umeå University, Sweden
  • Anders Ullén Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Pelvic Cancer, Genitourinary Oncology and Urology unit, Karolinska University Hospital, Stockholm, Sweden
  • Lars Holmberg Department of Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK.
  • Christel Häggström Department of Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Diagnostics and Intervention, Registry Center North, Umeå University, Umeå, SwedenDepartment of Diagnostics and Intervention, Registry Center North, Umeå University, Umeå, Sweden and
  • Fredrik Liedberg Department of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden

DOI:

https://doi.org/10.2340/1651-226X.2025.42756

Keywords:

bladder cancer, multidisciplinary team meeting, treatment recommendation, guidelines, scoring system, complexity factors

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 guideline-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 performing 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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2025-05-05

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Wihl, J., Oskar Hagberg, Firas Aljabery, Truls Gårdmark, Abolfazl Hosseini, Staffan Jahnson, … Fredrik Liedberg. (2025). Lower MeDiC score is associated with non-referral to multidisciplinary team meeting discussion in bladder cancer patients: a nationwide and population-based study. Acta Oncologica, 64, 616–622. https://doi.org/10.2340/1651-226X.2025.42756

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Vol. 64 (2025): Acta Oncologica

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Copyright (c) 2025 Jessica Wihl, Oskar Hagberg, Firas Aljabery, Truls Gårdmark, Abolfazl Hosseini, Staffan Jahnson, Tomas Jerlström, Viveka Ströck, Karin Söderkvist, Anders Ullén anders.ullen@sll.se, Lars Holmberg, Christel Häggström, Fredrik Liedberg

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