A Review of the Multidisciplinary Diagnosis of Interstitial Lung Diseases: A Retrospective Analysis in a Single UK Specialist Centre

Archives of Pulmonology and Respiratory Care
Review Article

Abstract 
Abstract A multidisciplinary team approach to diagnosis and management of interstitial lung diseases (ILD) is considered gold standard and an integral part of ILD management and guidelines. The accurate diagnosis and management of individuals with ILDs poses an interesting challenge in clinical practice. This is a single center retrospective review of electronic patient letters and multidisciplinary team (MDT) records spanning a five and half year time period. In this study we assessed the accuracy of prior ILD diagnosis, the methodology used to establish a correct diagnosis and how an MDT approach to diagnosis affected subsequent management. Our results demonstrate that a multidisciplinary approach to diagnosis within a single specialist ILD center can establish a diagnosis in the majority of cases when prior diagnosis is uncertain (76%). We also show that a prior diagnosis of idiopathic pulmonary fibrosis is deemed inaccurate in over fifty percent of cases after MDT discussion. Other ILD diagnoses fair better with an inaccurate prior diagnosis in a third of cases. Over time we demonstrate an increased utilisation of combined lung biopsy and radiological imaging to establish a diagnosis. However when diagnosis was deemed uncertain on radiological imaging alone, biopsy was seldom possible due to factors such as poor lung function or presence of comorbidities deeming biopsy as too high risk.

http://www.peertechz.com/Pulmonology-Respiratory-Care/pdf/APRC-1-105.pdf