Abstract
BACKGROUND: Multiple pulmonary nodules (MPNs) present diagnostic and management challenges, causing patient anxiety and inconsistent clinical recommendations. While multidisciplinary team (MDT) approaches benefit various chronic conditions, their association with improved outcomes for MPNs remains unexplored. METHODS: This prospective observational cohort study with nonrandomized, pathway-based group allocation enrolled 200 consecutive patients with newly diagnosed MPNs at a tertiary center (January-December 2023). Participants received either MDT collaborative management (n=100) or routine care (n=100) based on their healthcare entry point. The MDT intervention integrated risk stratification, specialist coordination, structured education, and psychological support. Primary outcomes were health knowledge and health behavior scores at 6 months, assessed using a validated 20-item lung nodule health knowledge and behavior questionnaire (each domain scored 0-100). Secondary outcomes included disease benefit perception, health literacy, coping strategies, self-management capabilities, quality of life (WHOQOL-BREF), and patient satisfaction. RESULTS: Baseline characteristics were comparable between groups. At 6 months, the MDT cohort showed significantly higher health knowledge (85.7 ± 6.8 vs 68.5 ± 7.3, P<0.01) and health behaviors (88.3 ± 7.1 vs 71.2 ± 7.8, P<0.01), with large effect sizes (Cohen's d>2.2). MDT management was associated with greater improvements across all Benefit Finding Scale domains, enhanced positive coping (30.2 ± 3.6 vs 24.8 ± 3.9, P<0.01), reduced negative coping (7.2 ± 2.9 vs 10.8 ± 3.2, P<0.01), and superior health literacy scores. Quality of life improvements favored MDT across all WHOQOL-BREF domains. Patient satisfaction reached 98% with MDT versus 88% with routine care (P = 0.01). CONCLUSION: MDT collaborative management is associated with substantially improved patient-centered outcomes for individuals with MPNs, providing evidence that supports further evaluation and implementation of structured multidisciplinary approaches for this complex population.