Singh Sheetu, Sharma Bharat Bhushan, Bairwa Mohan, Gothi Dipti, Desai Unnati, Joshi Jyotsna M, Talwar Deepak, Singh Abhijeet, Dhar Raja, Sharma Ambika, Ahluwalia Bineet, Mangal Daya K, Jain Nirmal K, Pilania Khushboo, Hadda Vijay, Koul Parvaiz A, Luhadia Shanti Kumar, Swarnkar Rajesh, Gaur Shailender Nath, Ghoshal Aloke G, Nene Amita, Jindal Arpita, Jankharia Bhavin, Ravindran Chetambath, Choudhary Dhruv, Behera Digambar, Christopher D J, Khilnani Gopi C, Samaria Jai Kumar, Singh Harpreet, Gupta Krishna Bihari, Pilania Manju, Gupta Manohar L, Misra Narayan, Singh Nishtha, Gupta Prahlad R, Chhajed Prashant N, Kumar Raj, Chawla Rajesh, Jenaw Rajendra K, Chawla Rakesh, Guleria Randeep, Agarwal Ritesh, Narsimhan R, Katiyar Sandeep, Mehta Sanjeev, Dhooria Sahajal, Chowdhury Sushmita R, Jindal Surinder K, Katiyar Subodh K, Chaudhri Sudhir, Gupta Neeraj, Singh Sunita, Kant Surya, Udwadia Zarir, Singh Virendra, Raghu Ganesh
Department of Respiratory Medicine, SMS Medical College, Jaipur, Rajasthan, India.
Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India.
Lung India. 2020 Jul-Aug;37(4):359-378. doi: 10.4103/lungindia.lungindia_275_20.
Interstitial lung disease (ILD) is a complex and heterogeneous group of acute and chronic lung diseases of several known and unknown causes. While clinical practice guidelines (CPG) for idiopathic pulmonary fibrosis (IPF) have been recently updated, CPG for ILD other than IPF are needed.
A working group of multidisciplinary clinicians familiar with clinical management of ILD (pulmonologists, radiologist, pathologist, and rheumatologist) and three epidemiologists selected by the leaderships of Indian Chest Society and National College of Chest Physicians, India, posed questions to address the clinically relevant situation. A systematic search was performed on PubMed, Embase, and Cochrane databases. A modified GRADE approach was used to grade the evidence. The working group discussed the evidence and reached a consensus of opinions for each question following face-to-face discussions.
Statements have been made for each specific question and the grade of evidence has been provided after performing a systematic review of literature. For most of the questions addressed, the available evidence was insufficient and of low to very low quality. The consensus of the opinions of the working group has been presented as statements for the questions and not as an evidence-based CPG for the management of ILD.
This document provides the guidelines made by consensus of opinions among experts following discussion of systematic review of evidence pertaining to the specific questions for management of ILD other than IPF. It is hoped that this document will help the clinician understand the accumulated evidence and help better management of idiopathic and nonidiopathic interstitial pneumonias.
间质性肺疾病（ILD）是一组复杂且异质性的急慢性肺部疾病，病因已知和未知者均有。虽然特发性肺纤维化（IPF）的临床实践指南（CPG）最近已更新，但仍需要针对IPF以外的ILD的CPG。
一个由熟悉ILD临床管理的多学科临床医生（肺科医生、放射科医生、病理科医生和风湿科医生）组成的工作组，以及由印度胸科学会和印度国家胸科医师学院领导层挑选的三名流行病学家，提出了一些问题以应对临床相关情况。在PubMed、Embase和Cochrane数据库上进行了系统检索。采用改良的GRADE方法对证据进行分级。工作组讨论了证据，并在面对面讨论后就每个问题达成了意见共识。
针对每个具体问题都发表了声明，并在对文献进行系统综述后提供了证据等级。对于所涉及的大多数问题，现有证据不足，质量低至极低。工作组的意见共识已作为问题的声明呈现，而非作为ILD管理的循证CPG。
本文档提供了在对与IPF以外的ILD管理的具体问题相关的证据进行系统综述讨论后，专家们达成的意见共识指南。希望本文档能帮助临床医生了解积累的证据，并有助于更好地管理特发性和非特发性间质性肺炎。
