Multidisciplinary consultation offered at the Children’s Hospital of Fudan University help cure undiagnosable pediatric cases.
When patients visit hospitals, they expect doctors to identify their diseases so they can be treated. But despite the rapid development of medical technology nowadays, there are certain cases where even medical professionals cannot give a diagnosis.
On April 9, Children’s Hospital of Fudan University, the country’s best pediatric hospital according to a number of domestic authoritative rankings, founded a multidisciplinary consultation center for undiagnosable diseases. The center is located in an ad hoc facility equipped with six rooms of various sizes to accommodate group discussions on complicated ailments.
Undiagnosable diseases refer to complicated illnesses and symptoms without a confirmed cause, making them impossible for doctors to deliver corresponding treatments. Pediatric patients with undiagnosable diseases, if not treated in time, are likely to suffer irreversible consequences to their well-being later in life even when they survive.
Medics pose at the entrance of the Multidisciplinary Consultation Center for Undiagnosable Diseases
In recent years, multidisciplinary teams (MDTs) have emerged as an effective approach to tackle undiagnosable diseases. According to Zhai Xiaowen, deputy director of the hospital, there is an obvious limitation in the traditional single-specialization diagnostic approach, where the patient can only receive opinions from one doctor of one specialization at one time. It costs families a considerable amount of time, money and energy, but often ends up with ineffective monotherapy or overtreatment. In comparison, MDTs, composed of medics with multiple but complementary expertise, can provide tailored health care for each patient. After MDTs, for the next step, the hospital will reallocate its medical resources and further tailor treatments to individual needs, Zhai Xiaowen said.
One of the first patients the center received was a seven-year-old boy from Tianjin, who suffered multiple symptoms, including mouth ulcer, perianal abscess, diarrhea and recurrent fevers. Having sought treatment across Tianjin and Beijing, he was diagnosed by Beijing Children’s Hospital with early-onset inflammatory bowel disease induced by interleukin-10 receptor defects. The boy was transferred to Children’s Hospital of Fudan University, which pioneered treating this disease using stem cell transplantation with a recovery rate of over 70%. In the newly opened multidisciplinary consultation center, specialists of gastroenterology, immunology, surgery and hematology together deliberated on the boy’s conditions and hammered out a treatment plan, to the great comfort of the boy’s family.
Since 2016, the Children’s Hospital of Fudan University has made a series of efforts to crack undiagnosable diseases, starting with the launch of China’s first pediatric Undiagnosable Diseases Program (UDP). The program brought together 50 medical experts specialized in pathology, clinical treatment, molecular diagnostics, medical imaging and medical ethics. Two years later, the hospital set up an outpatient clinic for rare diseases. Now the clinic covers 36 rare diseases and has received almost 7,000 pediatric patients as of 2019.
Though the center was recently opened, the practice of MDTs has been in place for a while. Before the launch of the center, the hospital had held multidisciplinary group consultations for nearly 800 pediatric patients with rare diseases, successfully delivering diagnoses for 70% of them. According to the hospital, multidisciplinary collaboration worked well in treating genetic syndromes, immunodeficiency disorders, inherited metabolic disorders and rare malignant tumors.
In the past years, the 27 MDT outpatient branches of the hospital have provided personalized medicine for over 1,100 times, with an average clinical remission rate of over 70%. Thanks to MDTs, the hospital has made remarkable advances in the diagnosis of Kawasaki disease, precision medicine for complex partial seizure and hematopoietic stem cell transplantation for various rare diseases. While building MDTs, the hospital has also boosted research collaboration of physicians across different medical institutions, and so far 20 clinical consensus statements and over 200 articles on undiagnosable and rare diseases have been published.
The multidisciplinary consultation center at Children’s Hospital of Fudan University aims to provide health care for children all over the country. According to Huang Guoying, director of Children’s Hospital of Fudan University, the hospital will further optimize its medical services by bolstering interdisciplinary health research and streamlining patient visits. “We will also preserve these children’s medical records for prognosis and follow-up in the long term,” said Huang.
Editor: Deng Jianguo, Li Yijie
