Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case-cohort study.
| Τίτλος | Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case-cohort study. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Walsh, S. L. F., Maher T. M., Kolb M., Poletti V., Nusser R., Richeldi L., Vancheri C., Wilsher M. L., Antoniou K. M., Behr J., Bendstrup E., Brown K., Calandriello L., Corte T. J., Cottin V., Crestani B., Flaherty K., Glaspole I., Grutters J., Inoue Y., Kokosi M., Kondoh Y., Kouranos V., Kreuter M., Johannson K., Judge E., Ley B., Margaritopoulos G., Martinez F. J., Molina-Molina M., Morais A., Nunes H., Raghu G., Ryerson C. J., Selman M., Spagnolo P., Taniguchi H., Tomassetti S., Valeyre D., Wijsenbeek M., Wuyts W., Hansell D., & Wells A. |
| Corporate Authors | IPF Project Consortium |
| Journal | Eur Respir J |
| Volume | 50 |
| Issue | 2 |
| Date Published | 2017 08 |
| ISSN | 1399-3003 |
| Λέξεις κλειδιά | Clinical Competence, Diagnosis, Differential, Diagnostic Techniques, Respiratory System, Dimensional Measurement Accuracy, Female, Hospitals, University, Humans, Idiopathic Pulmonary Fibrosis, International Cooperation, Male, Middle Aged, Prognosis, Pulmonologists, Quality of Health Care, Referral and Consultation, Reproducibility of Results |
| Abstract | We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts.A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (κ). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the C-index.A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (κ=0.65, IQR 0.53-0.72, p<0.0001) than academic physicians (κ=0.56, IQR 0.45-0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (κ=0.54, IQR 0.45-0.64, p<0.0001). The prognostic accuracy of academic physicians with >20 years of experience (C-index=0.72, IQR 0.0-0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70-0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72-0.75).Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts. |
| DOI | 10.1183/13993003.00936-2017 |
| Alternate Journal | Eur Respir J |
| PubMed ID | 28860269 |
| Grant List | P30 GM106392 / GM / NIGMS NIH HHS / United States |
