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Respirology. 2016 Nov;21(8):1438-1444. doi: 10.1111/resp.12850. Epub 2016 Jul 18.

Clinical impact of the interstitial lung disease multidisciplinary service.

Author information

1
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. helen.jo@sydney.edu.au.
2
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia. helen.jo@sydney.edu.au.
3
Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
4
Faculty of Medicine, Monash University, Melbourne, Victoria, Australia.
5
Department of Radiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
6
Department of Anatomical Pathology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
7
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
8
Department of Radiology, The Alfred Hospital, Melbourne, Victoria, Australia.
9
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Abstract

BACKGROUND AND OBJECTIVE:

Multidisciplinary discussions (MDDs) have been shown to improve diagnostic accuracy in interstitial lung disease (ILD) diagnosis. However, their clinical impact on patient care has never been clearly demonstrated. We describe the effect that an ILD multidisciplinary service has upon the diagnosis and management of patients with suspected ILD.

METHODS:

Patients at two specialized centres with suspected ILD underwent ILD multidisciplinary team review (ILD-MDT) (standard ILD clinic visit and diagnostic review at ILD-MDD). We compared changes in ILD diagnosis and management at referral to those following the ILD-MDT.

RESULTS:

Ninety patients, 60% males (54/90), aged 67.3 years (SD = 11.4) were reviewed for suspected ILD. Overall, the ILD-MDT resulted in a change in specific ILD diagnosis in 48/90 (53%) patients. Of the 27 patients referred with a diagnosis of idiopathic pulmonary fibrosis (IPF), the diagnosis was changed at MDD in 10 patients. In contrast, seven patients had their diagnosis changed to IPF. There was also a significant reduction in 'unclassifiable' diseases and disease behaviour classifications provided additional information beyond ILD diagnosis.

CONCLUSION:

Dedicated tertiary ILD-MDT service has an important clinical impact on the care of the ILD patient, with frequent changes in ILD diagnosis and subsequent management. Further research to investigate long-term clinical outcomes of ILD-MDT is required.

KEYWORDS:

idiopathic interstitial pneumonia; idiopathic pulmonary fibrosis; interstitial lung disease; multidisciplinary

PMID:
27427515
DOI:
10.1111/resp.12850
[Indexed for MEDLINE]

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