Histologist's original opinion compared with multidisciplinary team in determining diagnosis in interstitial lung disease

被引：12

作者：

Burge, P. S. ^{[1
]}

Reynolds, J. ^{[1
]}

Trotter, S. ^{[1
]}

Burge, G. A. ^{[1
]}

Walters, G. ^{[1
]}

机构：

[1] Birmingham Heartlands Hosp, Interstitial Lung Dis Serv, Birmingham B9 5SS, W Midlands, England

来源：

THORAX | 2017年 / 72卷 / 03期

关键词：

INTEROBSERVER AGREEMENT;

D O I：

10.1136/thoraxjnl-2016-208776

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Guidelines recommend that multidisciplinary interstitial lung disease meeting (ILD MDT) decisions become the gold standard for diagnosis, replacing the histologist from this position, and identify this as requiring supportive evidence. We have compared diagnoses from lung biopsy material made by expert histologists with the subsequent consensus opinion from a properly constituted ILD MDT in 71 consecutive patients referred to a regional thoracic unit. MDT changed the original histological diagnoses in 30% (95% CI 19.3% to 41.6%) and strengthened the diagnoses from probable to confident in a further 17% ( 95% CI 9.1% to 27.7%). The assessment of hypersensitivity pneumonitis, non-necrotising granulomas and organising pneumonia accounted for the majority of the changes.

引用

页码：280 / 281

页数：2

共 10 条

[1] Idiopathic interstitial pneumonia - Do community and academic physicians agree on diagnosis? [J].

Flaherty, Kevin R. ;

Andrei, Adin-Cristian ;

King, Talmadge E., Jr. ;

Raghu, Ganesh ;

Colby, Thomas V. ;

Wells, Athol ;

Bassily, Nadir ;

Brown, Kevin ;

du Bois, Roland ;

Flint, Andrew ;

Gay, Steven E. ;

Gross, Barry H. ;

Kazerooni, Ella A. ;

Knapp, Robert ;

Louvar, Edmund ;

Lynch, David ;

Nicholson, Andrew G. ;

Quick, John ;

Thannickal, Victor J. ;

Travis, William D. ;

Vyskocil, James ;

Wadenstorer, Frazer A. ;

Wilt, Jeffrey ;

Toews, Galen B. ;

Murray, Susan ;

Martinez, Fernando J. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2007, 175 (10) :1054-1060

[2] Evaluating the interstitial lung disease multidisciplinary meeting: a survey of expert centres [J].

Jo, Helen E. ;

Corte, Tamera J. ;

Moodley, Yuben ;

Levin, Kovi ;

Westall, Glen ;

Hopkins, Peter ;

Chambers, Daniel ;

Glaspole, Ian .

BMC PULMONARY MEDICINE, 2016, 16

[3]

National Institute for Health and Care Excellence, 2013, ID PULM FIBR AD DIAG

[4] Radiological versus Histopathological Diagnosis of Usual Interstitial Pneumonia in the Clinical Practice: Does It Have Any Survival Difference? [J].

Quadrelli, Silvia ;

Molinari, Luciana ;

Ciallella, Lorena ;

Carlos Spina, Juan ;

Sobrino, Edgardo ;

Chertcoff, Julio .

RESPIRATION, 2010, 79 (01) :32-37

[5] An Official ATS/ERSARS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management [J].

Raghu, Ganesh ;

Collard, Harold R. ;

Egan, Jim J. ;

Martinez, Fernando J. ;

Behr, Juergen ;

Brown, Kevin K. ;

Colby, Thomas V. ;

Cordier, Jean-Francois ;

Flaherty, Kevin R. ;

Lasky, Joseph A. ;

Lynch, David A. ;

Ryu, Jay H. ;

Swigris, Jeffrey J. ;

Wells, Athol U. ;

Ancochea, Julio ;

Bouros, Demosthenes ;

Carvalho, Carlos ;

Costabel, Ulrich ;

Ebina, Masahito ;

Hansell, David M. ;

Johkoh, Takeshi ;

Kim, Dong Soon ;

King, Talmadge E., Jr. ;

Kondoh, Yasuhiro ;

Myers, Jeffrey ;

Mueller, Nestor L. ;

Nicholson, Andrew G. ;

Richeldi, Luca ;

Selman, Moises ;

Dudden, Rosalind F. ;

Griss, Barbara S. ;

Protzko, Shandra L. ;

Schuenemann, Holger J. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183 (06) :788-824

[6] Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis [J].

Thomeer, M. ;

Demedts, M. ;

Behr, J. ;

Buhl, R. ;

Costabel, U. ;

Flower, C. D. R. ;

Verschakelen, J. ;

Laurent, F. ;

Nicholson, A. G. ;

Verbeken, E. K. ;

Capron, F. ;

Sardina, M. ;

Corvasce, G. ;

Lankhorst, I. .

EUROPEAN RESPIRATORY JOURNAL, 2008, 31 (03) :585-591

[7] Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease: a case-cohort study [J].

Walsh, Simon L. F. ;

Wells, Athol U. ;

Desai, Sujal R. ;

Poletti, Venerino ;

Piciucchi, Sara ;

Dubini, Alessandra ;

Nunes, Hilario ;

Valeyre, Dominique ;

Brillet, Pierre Y. ;

Kambouchner, Marianne ;

Morais, Antonio ;

Pereira, Jose M. ;

Moura, Conceicao Souto ;

Grutters, Jan C. ;

van den Heuvel, Daniel A. ;

van Es, Hendrik W. ;

van Oosterhout, Matthijs F. ;

Seldenrijk, Cornelis A. ;

Bendstrup, Elisabeth ;

Rasmussen, Finn ;

Madsen, Line B. ;

Gooptu, Bibek ;

Pomplun, Sabine ;

Taniguchi, Hiroyuki ;

Fukuoka, Junya ;

Johkoh, Takeshi ;

Nicholson, Andrew G. ;

Sayer, Charlie ;

Edmunds, Lilian ;

Jacob, Joseph ;

Kokosi, Maria A. ;

Myers, Jeff Rey L. ;

Flaherty, Kevin R. ;

Hansell, David M. .

LANCET RESPIRATORY MEDICINE, 2016, 4 (07) :557-565

[8] Interobserver agreement for the ATS/ERS/JRS/ALAT criteria for a UIP pattern on CT [J].

Walsh, Simon L. F. ;

Calandriello, Lucio ;

Sverzellati, Nicola ;

Wells, Athol U. ;

Hansell, David M. .

THORAX, 2016, 71 (01) :45-51

[9] Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish thoracic society [J].

Wells, A. U. ;

Hirani, N. .

THORAX, 2008, 63 :v1-v58

[10] Histopathologic diagnosis in diffuse lung disease - An ailing gold standard [J].

Wells, AU .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2004, 170 (08) :828-829

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