Systematic review and single-arm meta-analysis of the clinical value of multidisciplinary team-based multimodal interventions in pulmonary nodule management.

BACKGROUND

Pulmonary nodules are highly prevalent and exhibit substantial heterogeneity. Traditional single-discipline management has limitations in risk assessment and precise stratification. Multidisciplinary team (MDT)-based management, which integrates cross-specialty collaborative evaluation, has gradually emerged; however, its clinical value remains controversial and warrants comprehensive assessment through systematic review.

METHODS

This study was conducted in strict accordance with the PRISMA statement and was registered on PROSPERO. A systematic literature search was performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library for studies published up to December 2025. Two independent reviewers conducted literature screening, data extraction, and quality assessment. Observational studies involving MDT-based pulmonary nodule management were included. Cohort studies were evaluated using the Newcastle-Ottawa Scale (NOS), whereas studies with diagnostic evaluation characteristics were assessed using QUADAS-2. Statistical analyses were conducted using R software (version 4.4.2). Heterogeneity was assessed using the I² test, and either fixed-effects or random-effects models were applied to pool effect sizes. Subgroup analyses were performed to explore sources of heterogeneity, sensitivity analyses were conducted using a leave-one-out approach, and publication bias was assessed via funnel plots and Egger's test.

RESULTS

A total of 10 observational studies involving 7,658 patients were included, among which 8 studies with complete outcome data were used for the core meta-analysis. The pooled positive predictive value (PPV) of MDT-based pulmonary nodule management was 0.766 (95% CI: 0.643-0.913). The pooled guideline adherence rate was 0.766 (95% CI: 0.386-0.945). The pooled lung cancer diagnosis rate was 0.120 (95% CI: 0.053-0.210), and the pooled proportion of early-stage (I-II) lung cancer among diagnosed cases was 0.741 (95% CI: 0.422-0.918). In addition, qualitative synthesis suggested that MDT-based management may contribute to reducing unnecessary benign pulmonary nodule resection in selected clinical settings.

CONCLUSION

MDT-based pulmonary nodule management programs were associated with relatively favorable reported outcomes in diagnostic-related metrics and guideline adherence across included studies. Further well-designed comparative studies are needed to validate these findings.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420261295367.