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虚拟多中心多学科讨论能否改善间质性肺疾病的诊断与管理?一项跨多机构的回顾性队列研究。

Can a virtual multi-centre multi-disciplinary discussion improve the diagnosis and management of interstitial lung disease? A retrospective cohort study across multiple institutions.

作者信息

Seluk Lior, Deri Ofir, Furie Nadav, Shafran Inbal, Marom Edith M, Ofek Efrat, Perelman Marina, Lidar Merav, Ravah Osnat M, Segal Mike, Peled Michael, Levy Liran

机构信息

National Jewish Health, Denver, Colorado, USA

Tel Aviv University, Tel Aviv, Israel.

出版信息

BMJ Open. 2025 Jun 17;15(6):e098549. doi: 10.1136/bmjopen-2024-098549.

Abstract

INTRODUCTION

Multi-disciplinary discussions (MDDs) improve diagnosis and management of interstitial lung disease (ILD). The value of a virtual multi-centre MDD (V-MCMDD) incorporating expertise from multiple institutions remains underexplored. This study aimed to evaluate the impact of a V-MCMDD on diagnosis and management in ILD.

METHODS

We conducted a retrospective multi-centre cohort study involving tertiary and secondary hospital clinics, private practices and community outpatient centres, all participating via a virtual platform. Between August 2020 and June 2023, patient cases were reviewed through V-MCMDDs, which included clinical, radiological, pathological and laboratory data. Each case was discussed to reach a consensus diagnosis and management plan.

RESULTS

Following the V-MCMDD review, the diagnosis was revised in 51% of patients (p=0.031), and management plans were modified in 41% of cases. A significant shift in treatment was observed in patients with changed diagnoses vs unchanged diagnoses (p value=0.002).

CONCLUSIONS

Our findings suggest that the implementation of V-MCMDDs can be valuable in the diagnostic and therapeutic process for ILD. Incorporating input from multiple centres via a virtual format can lead to significant changes in both diagnosis and management, potentially improving patient outcomes.

摘要

引言

多学科讨论(MDDs)可改善间质性肺疾病(ILD)的诊断和管理。整合多个机构专业知识的虚拟多中心MDD(V-MCMDD)的价值仍未得到充分探索。本研究旨在评估V-MCMDD对ILD诊断和管理的影响。

方法

我们进行了一项回顾性多中心队列研究,涉及三级和二级医院诊所、私人诊所和社区门诊中心,所有机构均通过虚拟平台参与。在2020年8月至2023年6月期间,通过V-MCMDD对患者病例进行了回顾,其中包括临床、放射学、病理学和实验室数据。对每个病例进行讨论以达成共识诊断和管理计划。

结果

经过V-MCMDD评估后,51%的患者诊断被修订(p=0.031),41%的病例管理计划被修改。诊断改变的患者与诊断未改变的患者相比,治疗有显著变化(p值=0.002)。

结论

我们的研究结果表明,实施V-MCMDD在ILD的诊断和治疗过程中可能具有重要价值。通过虚拟形式整合多个中心的意见可导致诊断和管理方面的显著变化,有可能改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b93/12182146/66b9d4f4e261/bmjopen-15-6-g001.jpg

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