Cottin Vincent, Martinez Fernando J, Smith Vanessa, Walsh Simon L F
Louis Pradel Hospital, Reference Centre for Rare Pulmonary Diseases, Hospices Civils de Lyon, Lyon, France
Claude Bernard University Lyon 1, UMR754, INRAE, Member of OrphaLung, RespiFil, Radico-ILD and ERN-LUNG, Lyon, France.
Eur Respir Rev. 2022 Sep 7;31(165). doi: 10.1183/16000617.0003-2022. Print 2022 Sep 30.
Multidisciplinary team (MDT) meetings, involving the integrated collaboration of healthcare professionals, are increasingly used in clinical practice to inform the diagnosis and treatment of interstitial lung diseases (ILDs). Over time, the assessment of patients with ILD has transitioned from discussions among clinicians, radiologists and pathologists to the inclusion of a broader range of clinical data and specialist expertise. Studies have shown that a multidisciplinary approach can have many benefits for the clinical care of patients with ILD by improving the diagnostic confidence for different ILDs and guiding treatment decisions. The utility of MDT discussions for diagnosis, monitoring disease progression and management decisions, will need to be considered based on how it is best positioned in the diagnostic and therapeutic process, as well as the practicality and challenges of its use. There are also uncertainties and heterogeneity concerning the optimal practices of MDT meetings in ILD care. In this review, we describe recent developments refining the approach to MDTs in clinical practice, including who should be involved in the MDTs, when it is most needed, their use in patient management, challenges in their implementation, and ongoing controversies in the field that need further research.
多学科团队(MDT)会议涉及医疗保健专业人员的综合协作,在临床实践中越来越多地用于指导间质性肺疾病(ILD)的诊断和治疗。随着时间的推移,ILD患者的评估已从临床医生、放射科医生和病理学家之间的讨论,转变为纳入更广泛的临床数据和专家专业知识。研究表明,多学科方法通过提高对不同ILD的诊断信心和指导治疗决策,可为ILD患者的临床护理带来诸多益处。MDT讨论在诊断、监测疾病进展和管理决策方面的效用,需要根据其在诊断和治疗过程中的最佳定位以及使用的实用性和挑战来考虑。在ILD护理中,MDT会议的最佳实践也存在不确定性和异质性。在本综述中,我们描述了临床实践中优化MDT方法的最新进展,包括MDT应包括哪些人员、何时最需要MDT、其在患者管理中的应用、实施中的挑战以及该领域需要进一步研究的持续争议。