Diagnostic ability of multidisciplinary discussion in interstitial lung diseases and rare lung diseases

The lessons contained herein were learned from a four-year multidisciplinary discussion (MDD) on interstitial lung diseases (ILD).

ILDs describe a heterogeneous collection of lung disorders. MDD has become the gold standard in the differential diagnosis of ILDs. The aim of this retrospective data analysis was to determine in how many patients MDD was able to establish a final diagnosis and in how many patients no clear diagnosis could be obtained.

This is a single-centre retrospective data analysis of patients presented to the MDD of a tertiary pulmonary hospital between January 2016 and December 2019. Patients with suspected ILDs were referred to the department either from other hospitals or from outpatient clinics. Criteria for inclusion were availability of the MDD report, radiological images, and histopathology report (if available). The MDD consists of at least three pulmonologists, one thoracic radiologist, and one thoracic histopathologist.

Three hundred and fourteen patients were discussed within four years; 224 (71%) received a definite diagnosis, while 90 (29%) received further recommendations. Fifty-five patients (18%) received a suspected diagnosis with a recommendation for further procedures, and 35 (11%) were judged as unclassified and received further recommendations. The most frequent diagnoses were IPF and sarcoidosis. Forty-four patients (14%) were discussed more than once, and 16 (36%) of those patients received a definite diagnosis after uncertainty following either the second MDD (13 patients), the third MDD (one patient), or the fifth MDD (two patients). Eight (16%) of these 44 patients remained without a definite diagnosis even after multiple MDD introductions.

Most of the patients discussed in the MDD received a definitive diagnosis. Only a few patients were seen as unclassifiable after multiple MDD introductions.

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