Multidisciplinary diagnosis of interstitial lung disease: a retrospective analysis

Abstract

Background: The accurate diagnosis of interstitial lung disease (ILD) can be a challenging process. Guidelines highlight the importance of a multidisciplinary discussion (MD) between experts but there is few data regarding its role in a real-life setting. Aim: To evaluate the diagnostic ability of our center’s MD. Methods: Retrospective analysis of patients (pts) referred for discussion at a tertiary hospital in Lisbon between 2015 and 2018. Results: 181 cases were referred for diagnostic discussion in the mentioned period. Mean age was 64, 51% were female. The MD established a definite diagnosis in 111 pts (61%); in 70 pts (39%) the MD was unable to provide a diagnosis but suggestions for further work up were given. 78 pts (43%) had a definite diagnosis of ILD, the most common being: idiopathic pulmonary fibrosis (n=21), hipersensitivity pneumonitis (n=15) and connective tissue associated ILD (n=12). 33 pts (18%) were diagnosed with diseases other than ILD. 106 pts (59%) had a pre discussion diagnosis provided by the the referring physician: in 42 (40%) this diagnosis was confirmed by the MD; in the majority of cases the MD resulted in a change of diagnosis (in 23% a different diagnosis was made; 37% had non classified ILD, in need for further work up). 75 pts had no preliminary diagnosis or multiple differential diagnoses pre discussion. The MD was able to establish a diagnosis in 44 (59%) of these. Conclusion: The MD was able to establish a definite diagnosis in 61% of the cases, including a modification in diagnosis in 60% of the pts with a previous diagnosis of ILD and a diagnosis in 59% of the pts with no diagnosis pre discussion, illustrating the importance of the multidisciplinary assessment.