The Role of the Multidisciplinary Team in the Management of Complex Cases of Liver Disease in a Peripheral Hospital: A Retrospective Analysis of MDT Registry

Background and Aims: In liver disease (LD), multidisciplinary teams (MDTs) support complex decision-making and may improve care delivery. The present study aims to evaluate the role of a multidisciplinary approach in complex cases of LD in a peripheral hospital. Methods: We retrospectively analyzed a prospectively maintained MDT registry. Since November 2023, consecutive complex cases referred to the Liver Disease Outpatient Clinic of Barone Lombardo Hospital were discussed in MDT meetings. The initial proposals of clinicians were compared with the decisions taken by the team to evaluate the appropriateness of prescribing imaging tests and the need for referral. The MDT also re-reviewed prior imaging and applied guideline-concordant criteria to minimize low-value testing. Results: Of 52 cases presented, 1 was excluded (non-hepatic lesion), leaving 51 patients analyzed. The median age was 60 years, 32 patients (62.7%) were female, and 27 patients (52.9%) had chronic LD. A total of 22 imaging tests and 1 liver biopsy were avoided, and no patients were referred to a secondary or tertiary hospital. Conclusions: The multidisciplinary approach in a peripheral hospital appears to improve the appropriateness of prescribing imaging tests with consequent reduction of costs and contrast-related adverse events. It also allows for a better allocation of resources and avoids unnecessary referrals to secondary and tertiary hospitals, with potential benefits for patient experience and diagnostic safety.