Systematic review of multidisciplinary team strategies and novel research in rare and complex clinical cases

Table 1 Electronic database search strategy

Database	Search terms	Limits applied
PubMed	(“Patient Care Team”[Mesh] OR “Interdisciplinary Communication”[Mesh] OR “Delivery of Health Care, Integrated”[Mesh] OR “Clinical Decision-Making”[Mesh] OR multidisciplinary[tiab] OR “multidisciplinary team”[tiab] OR MDT[tiab] OR interdisciplinary[tiab] OR interprofessional[tiab] OR “team-based care”[tiab] OR “integrated care”[tiab] OR “collaborative care”[tiab] OR “tumor board”[tiab] OR “tumour board”[tiab] OR “molecular tumor board”[tiab] OR “case conference”[tiab] OR “expert panel”[tiab] OR “precision medicine board”[tiab] OR “genomic board”[tiab]) AND (“Rare Diseases”[Mesh] OR “Neoplasms”[Mesh] OR “Cardiovascular Diseases”[Mesh] OR “Nervous System Diseases”[Mesh] OR “Congenital Abnormalities”[Mesh] OR “Autoimmune Diseases”[Mesh] OR rare disease*[tiab] OR complex condition*[tiab] OR oncology[tiab] OR cancer*[tiab] OR cardiology[tiab] OR neurology[tiab] OR congenital[tiab] OR autoimmune[tiab]) AND (“Precision Medicine”[Mesh] OR “Artificial Intelligence”[Mesh] OR “Genomics”[Mesh] OR “High-Throughput Nucleotide Sequencing”[Mesh] OR “Decision Support Systems, Clinical”[Mesh] OR precision medicine[tiab] OR genomic*[tiab] OR AI[tiab] OR “artificial intelligence”[tiab] OR “machine learning”[tiab] OR “clinical decision support”[tiab])	Humans; English; 2013-2025
Cochrane Library	(Multidisciplinary OR interdisciplinary OR interprofessional OR “team-based care” OR “integrated care” OR “collaborative care” OR “tumor board” OR “tumour board” OR “case conference” OR “expert panel”) AND (rare OR complex OR oncology OR cancer OR cardiology OR neurology OR congenital OR autoimmune)	2013-2025

MDT: Multidisciplinary team.

Table 2 QUADAS-2 summary table

Domain	Low risk	Unclear risk	High risk
Patient selection	21-24	6-8	0
MDT process/index test	24-28	3-4	0
Reference standard	18-20	9-12	0
Flow and timing	20-24	7-8	0

MDT: Multidisciplinary team.

Table 3 Characteristics and outcomes of included studies

Domain	Summary	Representative references
Clinical area	Studies predominantly addressed oncology, with additional representation from cardiology, neurology, and autoimmune diseases. Rare cancers, congenital cardiovascular disease, complex neurological disorders, and atypical autoimmune syndromes were commonly reported	Oncology:[18,19,22,26-39,45,46]; cardiology/congenital heart disease:[21,40,41]; neurology:[42,47]; autoimmune/complex disease contexts:[43,48]
MDT composition	MDTs typically included physicians and surgeons, with regular involvement of radiologists and pathologists. Expanded MDTs incorporated molecular pathologists, geneticists, nurses, allied health professionals, and bioinformaticians in complex cases	[18,19,23,26-28,30,33-38,42,45,46]
MDT model	MDT formats included traditional tumor boards, molecular tumor boards, interdisciplinary case conferences, and virtual or network-based MDTs, particularly for rare or geographically dispersed cases	Traditional MDTs:[19,22,29,30,36,39,42]; molecular tumor boards:[18,23,26-28,31,34,38]; virtual/network MDTs:[23,36-37,44]
Innovation	Studies reported integration of genomics, precision medicine, high-throughput sequencing, and artificial intelligence-assisted clinical decision support within MDT workflows, particularly in oncology and rare disease care	Genomics/NGS:[18,26-28,31-35,38]; precision medicine:[18,26-28,44]; AI/ML decision support:[29,37]
Outcomes	MDT involvement was associated with improved diagnostic accuracy, treatment modification, and optimized care pathways. Evidence for survival and quality-of-life benefits was limited and heterogeneous, with outcomes often reported as intermediate or process-level measures	Diagnostic/treatment modification:[18,23,26-28,30,34,38]; care pathway optimization/process outcomes:[21,23,38,42,44]; limited survival/quality-of-life data:[19,22,30,39]

MDT: Multidisciplinary team; NGS: Next-generation sequencing; AI: Artificial intelligence; ML: Machine learning.

Table 4 Evidence synthesis of included studies[18-22,26,27,45-49]

Dimensions	Findings
Clinical domains	Oncology (dominant), cardiology, autoimmune disease
MDT composition	Oncologists, surgeons, radiologists, pathologists, geneticists, cardiologists, nurses, bioinformaticians
MDT format	In-person MDTs, molecular tumor boards, virtual/tele-MDTs
Innovation integrated	NGS, molecular profiling, AI/ML decision tools, liquid biopsy, precision therapeutics
Primary MDT function	Diagnostic clarification, treatment selection, escalation/de-escalation decisions
Outcomes reported	Diagnostic reclassification, altered management, feasibility of innovation integration
Survival/quality-of-life data	Limited direct reporting; mostly surrogate and process outcomes
Study design heterogeneity	Case reports → cohorts → qualitative and consensus studies
Geographic distribution	Europe, North America, Latin America

MDT: Multidisciplinary team; NGS: Next-generation sequencing; AI: Artificial intelligence; ML: Machine learning.