The role of multidisciplinary discussion in diagnosis and management of interstitial lung diseases: a retrospective evaluation of a single-center 10 years' of experience.

Abstract

Purpose: The importance of multidisciplinary discussion (MDD) in interstitial lung diseases (ILDs) is well known. The aim of this study was to describe the 10-year experience of the MDD at the Pisa University Hospital in diagnosis and management of ILDs.

Material and methods: A single-center retrospective observational study was conducted at the Pisa University Hospital. A multidisciplinary group for ILDs diagnosis was instituted in 2012, and all patients referred till August 2022 were included.

Results: Altogether 1240 patients were evaluated. At baseline assessment, 772 common multidisciplinary diagnoses were achieved, while in 458 cases it was not possible to obtain a definite diagnosis. Most frequent multidisciplinary diagnoses were idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), and smoking-related ILDs. In 9% of cases a histological evaluation was performed, leading to a diagnosis in 75% of cases. One-thousand and fourty-eight cases with at least one year of follow-up after the MDD were revised. Common diagnoses were confirmed or modified, while "diagnostic hypotheses" were changed into "revised diagnoses" or left as hypothesis as they still could not be confirmed. Among common diagnoses, 61% were confirmed, while 36% were not confirmed as patients did not perform further examinations or visits. Eighteen diagnoses were modified (3%). Among the "diagnostic hypotheses," 57% changed into "revised diagnoses." Only in 15% of cases a definite diagnosis was not achieved after the revision.

Conclusion: The role of MDD in ILDs' assessment and diagnosis was confirmed. A multidisciplinary approach should be considered in the long-term follow-up of ILDs, as diagnosis may change on the basis of clinical course.