Second Division, Dept of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
Second Division, Dept of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Eur Respir J. 2019 May 18;53(5). doi: 10.1183/13993003.02243-2018. Print 2019 May.
Multidisciplinary discussion (MDD) requiring close communication between specialists (clinicians, radiologists and pathologists) is the gold standard for the diagnosis of idiopathic interstitial pneumonias (IIPs). However, MDD by specialists is not always feasible because they are often separated by time and location. An online database would facilitate data sharing and MDD. Our aims were to develop a nationwide cloud-based integrated database containing clinical, radiological and pathological data of patients with IIPs along with a web-based MDD system, and to validate the diagnostic utility of web-based MDD in IIPs.Clinical data, high-resolution computed tomography images and lung biopsy slides from patients with IIPs were digitised and uploaded to separate servers to develop a cloud-based integrated database. Web-based MDD was performed using the database and video-conferencing to reach a diagnosis.Clinical, radiological and pathological data of 524 patients in 39 institutions were collected, uploaded and incorporated into the cloud-based integrated database. Subsequently, web-based MDDs with a pulmonologist, radiologist and pathologist using the database and video-conferencing were successfully performed for the 465 cases with adequate data. Overall, the web-based MDD changed the institutional diagnosis in 219 cases (47%). Notably, the MDD diagnosis yielded better prognostic separation among the IIPs than did the institutional diagnosis.This is the first study of developing a nationwide cloud-based integrated database containing clinical, radiological and pathological data for web-based MDD in patients with IIPs. The database and the web-based MDD system that we built made MDD more feasible in practice, potentially increasing accurate diagnosis of IIPs.
多学科讨论（MDD）需要专家（临床医生、放射科医生和病理学家）之间密切沟通，是特发性间质性肺炎（IIP）诊断的金标准。然而，由于专家们经常被时间和地点分隔开，因此进行 MDD 并不总是可行的。一个在线数据库将有助于数据共享和 MDD。我们的目标是开发一个全国性的基于云的综合数据库，其中包含 IIP 患者的临床、放射和病理数据，以及一个基于网络的 MDD 系统，并验证基于网络的 MDD 在 IIP 中的诊断效用。将 IIP 患者的临床数据、高分辨率计算机断层扫描图像和肺活检切片数字化并上传到单独的服务器，以开发基于云的综合数据库。使用该数据库和视频会议进行基于网络的 MDD。从 39 个机构收集了 524 名患者的临床、放射和病理数据，并上传到基于云的综合数据库中。随后，使用数据库和视频会议，由一名肺病专家、放射科医生和病理学家对 465 例数据充足的病例进行了成功的基于网络的 MDD。总体而言，基于网络的 MDD 改变了 219 例（47%）机构诊断。值得注意的是，与机构诊断相比，MDD 诊断在 IIP 之间产生了更好的预后分离。这是第一项开发全国性基于云的综合数据库的研究，其中包含 IIP 患者基于网络的 MDD 的临床、放射和病理数据。我们构建的数据库和基于网络的 MDD 系统使 MDD 在实践中更可行，可能会增加 IIP 的准确诊断。
