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Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case-cohort study.

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March1_IPF_paper_main_experts_v4.docxAccepted version173.28 kBMicrosoft WordView/Open
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Title: Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case-cohort study.
Authors: Walsh, SLF
Maher, TM
Kolb, M
Poletti, V
Nusser, R
Richeldi, L
Vancheri, C
Wilsher, ML
Antoniou, KM
Behr, J
Bendstrup, E
Brown, K
Calandriello, L
Corte, TJ
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, FJ
Molina-Molina, M
Morais, A
Nunes, H
Raghu, G
Ryerson, CJ
Selman, M
Spagnolo, P
Taniguchi, H
Tomassetti, S
Valeyre, D
Wijsenbeek, M
Wuyts, W
Hansell, D
Wells, A
IPF Project Consortium
Item Type: Journal Article
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 (κw). 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 (κw=0.65, IQR 0.53-0.72, p<0.0001) than academic physicians (κw=0.56, IQR 0.45-0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (κw=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.
Issue Date: 31-Aug-2017
Date of Acceptance: 30-May-2017
URI: http://hdl.handle.net/10044/1/51949
DOI: https://dx.doi.org/10.1183/13993003.00936-2017
ISSN: 0903-1936
Publisher: European Respiratory Society
Journal / Book Title: European Respiratory Journal
Volume: 50
Issue: 2
Copyright Statement: Copyright ©ERS 2017
Sponsor/Funder: National Institute for Health Research
British Lung Foundation
Funder's Grant Number: n/a
C17-3
Keywords: IPF Project Consortium
11 Medical And Health Sciences
Respiratory System
Publication Status: Published online
Article Number: 1700936
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



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