Richeldi Luca, Launders Naomi, Martinez Fernando, Walsh Simon L F, Myers Jeffrey, Wang Bonnie, Jones Mark, Chisholm Alison, Flaherty Kevin R
Unità Operativa Complessa di Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Respiratory Effectiveness Group, Cambridge, UK.
ERJ Open Res. 2019 Apr 1;5(2). doi: 10.1183/23120541.00209-2018. eCollection 2019 Apr.
Multidisciplinary team (MDT) diagnosis of interstitial lung disease (ILD) has been proposed as a gold standard, but there are no formal recommendations for MDT process or composition and limited knowledge regarding prevalence in routine practice. We performed a systematic evaluation of ILD diagnostic practice across a range of healthcare settings around the world. Electronic questionnaires were distributed across all global regions society and collaborators networks. Responses from 457 unique centres across 64 countries were included in the analysis. Of the 350 (76.6%) centres holding formal meetings, the majority held face-to-face MDT meetings (80%), for a minimum of 30 min (93%), and discussed diagnosis (96.9%) and patient management (94.9%) at the meetings. Compared with non-academic and academic non-ILD centres, ILD academic centres reported a higher ILD caseload, held more formal MDT meetings, and were more likely to include histopathology and rheumatology specialists in their diagnostic team. Of the centres holding MDT meetings, 5.5% routinely discussed all new cases at such meetings. An MDT approach to ILD diagnosis is consistently interpreted and widely implemented across a range of routine care settings around the world. This observation will inform future ILD diagnostic agreement studies and diagnostic pathway recommendations.
多学科团队(MDT)诊断间质性肺疾病(ILD)已被提议作为金标准,但对于MDT流程或组成没有正式建议,且在常规实践中关于其患病率的了解有限。我们对全球一系列医疗环境中的ILD诊断实践进行了系统评估。电子问卷被分发给全球所有地区的协会和合作网络。分析纳入了来自64个国家457个独立中心的回复。在350个(76.6%)召开正式会议的中心中,大多数召开面对面的MDT会议(80%),会议时长至少30分钟(93%),且在会议上讨论诊断(96.9%)和患者管理(94.9%)。与非学术和学术性非ILD中心相比,ILD学术中心报告的ILD病例量更高,召开的正式MDT会议更多,且其诊断团队更有可能包括组织病理学和风湿病学专家。在召开MDT会议的中心中,5.5%会在这类会议上常规讨论所有新病例。MDT诊断ILD的方法在全球一系列常规护理环境中得到了一致的解读和广泛的实施。这一观察结果将为未来的ILD诊断一致性研究和诊断途径建议提供参考。