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Setting up a parathyroid multidisciplinary team meeting: one year's experience, outcomes and learning points

Published online by Cambridge University Press:  07 March 2018

S H Hancox*
Affiliation:
Department of General Medicine, Eastbourne District General Hospital, UK
J D Sinnott
Affiliation:
Department of ENT, Eastbourne District General Hospital, UK
P Kirkland
Affiliation:
Department of ENT, Eastbourne District General Hospital, UK
D Lipscomb
Affiliation:
Department of Endocrinology, Eastbourne District General Hospital, UK
E Owens
Affiliation:
Department of Radiology, Eastbourne District General Hospital, UK
D C Howlett
Affiliation:
Department of Radiology, Eastbourne District General Hospital, UK
*
Address for correspondence: Dr Sarah H Hancox, Department of General Medicine, Eastbourne District General Hospital, Eastbourne BN21 2UD, UK E-mail: [email protected]

Abstract

Objective:

A parathyroid multidisciplinary team meeting was set up at East Sussex Healthcare Trust, from November 2014 to November 2015, in order to improve and streamline services for patients with parathyroid pathology.

Methods:

Data were collected on all new referrals for hyperparathyroidism, and on the outcomes for each patient discussed at the meeting, including the number of operations and management outcomes. A survey was sent out to the members of the multidisciplinary team meeting to determine their perception of its effectiveness.

Results:

Seventy-nine new referrals were discussed throughout the year; 43 per cent were recommended for surgery, 41 per cent had a trial of conservative or medical management before re-discussion, and 16 per cent required further imaging. Ninety-two per cent of patients underwent an ultrasound, single-photon emission computed tomography/computed tomography or nuclear medicine (sestamibi) scan prior to the meeting. All ultrasound scans were performed by a consultant radiologist.

Conclusion:

The multidisciplinary team meeting has been successful, with perceived benefits for patients, improved imaging evaluation and efficiency of referral pathways, leading to more appropriate patient management.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2018 

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References

1 Niederle, BE, Schmidt, G, Organ, CH, Niederle, B. Albert J and his surgeon: a historical reevaluation of the first parathyroidectomy. J Am Coll Surg 2006;202:181–90CrossRefGoogle Scholar
2 Akerström, G, Hellman, P. Primary hyperparathyroidism. Curr Opin Oncol 2004;16:17 CrossRefGoogle ScholarPubMed
3 Heath, DA. Primary hyperparathyroidism. Clinical presentation and factors influencing clinical management. Endocrinol Metab Clin North Am 1989;18:631–46CrossRefGoogle ScholarPubMed
4 Takahashi, H, Shimazawa, E, Horiuchi, N, Suda, T, Yamashita, K, Ogata, E. An estimation of the parathyroid hormone secretion rate in vitamin D deficient rats. Horm Metab Res 1978;10:161–7CrossRefGoogle ScholarPubMed
5 Gopinath, D, Jha, S. Multidisciplinary team meetings in urogynaecology. Int Urogynecol J 2015;26:1221–7CrossRefGoogle ScholarPubMed
6 Yassa, L, Cibas, ES, Benson, CB, Frates, MC, Doubilet, PM, Gawande, AA et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer 2007;111:508–16CrossRefGoogle ScholarPubMed
7 Bilezikian, JP, Brandi, ML, Eastell, R, Silverberg, SJ, Udelsman, R, Marcocci, C et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab 2014;99:3561–9CrossRefGoogle ScholarPubMed
8 Shapey, I, Jabbar, S, Khan, Z, Nicholson, J, Watson, R. Scan-directed mini-incision focused parathyroidectomy: how accurate is accurate enough? Ann R Coll Surg Engl 2017;99:123–8CrossRefGoogle ScholarPubMed