title: A Review of the Multidisciplinary Diagnosis of Interstitial Lung Diseases: A Retrospective Analysis in a Single UK Specialist Centre.
abstract: The accurate diagnosis and management of individuals with interstitial lung diseases (ILDs) poses an interesting challenge in clinical practice. A multidisciplinary team (MDT) approach is considered the gold standard. This is a single-centre retrospective review spanning a five-year period. We assessed the accuracy of prior ILD diagnosis, the methodology used to establish a correct diagnosis and how an MDT approach affected subsequent management. Our data supports an MDT approach in an experienced specialist ILD centre. We have demonstrated that diagnosis is often changed after an MDT review and that this impacts the subsequent management. Our results demonstrate that an MDT approach to diagnosis can establish a diagnosis in the majority of cases when prior diagnosis is uncertain (76%). We also show that a prior diagnosis of idiopathic pulmonary fibrosis is deemed inaccurate in over 50% of cases after MDT discussion. We have shown that during diagnostic uncertainty the considered gold standard of proceeding to a lung biopsy is not always feasible due to disease severity and comorbidities. In these circumstances, an MDT approach to diagnosis of ILDs combines clinical data with serial lung function and disease behavior, with or without responses to previous treatment trials to establish an accurate expert diagnosis.
authors.affiliation: North West Interstitial Lung Disease Unit, University Hospital of South Manchester, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. Nazia.Chaudhuri@uhsm.nhs.uk.
authors.forename: Nazia
authors.initials: N
authors.lastname: Chaudhuri
authors.affiliation: Aintree Chest Centre, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK. Lisa.Spencer@aintree.nhs.uk.
authors.forename: Lisa
authors.initials: L
authors.lastname: Spencer
authors.affiliation: North West Interstitial Lung Disease Unit, University Hospital of South Manchester, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. Melanie.Greaves@uhsm.nhs.uk.
authors.forename: Melanie
authors.initials: M
authors.lastname: Greaves
authors.affiliation: North West Interstitial Lung Disease Unit, University Hospital of South Manchester, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. paul.bishop@uhsm.nhs.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Bishop
authors.affiliation: North West Interstitial Lung Disease Unit, University Hospital of South Manchester, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. antshuman.chaturvedi@uhsm.nhs.uk.
authors.forename: Anshuman
authors.initials: A
authors.lastname: Chaturvedi
authors.affiliation: North West Interstitial Lung Disease Unit, University Hospital of South Manchester, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. Colm.Leonard@uhsm.nhs.uk.
authors.forename: Colm
authors.initials: C
authors.lastname: Leonard
keywords: diagnosis; idiopathic pulmonary fibrosis; interstitial lung disease; multidisciplinary team