The Diagnostic Yield of the Multidisciplinary Discussion in Patients With COVID-19 Pneumonia

Frontiers in Medicine

article

Fiorella Calabrese¹  Stefania Edith Vuljan¹  Dario Gregori¹  Andrea Crisanti²  Elisabetta Balestro¹  Paolo Spagnolo¹  Federica Pezzuto¹  Chiara Giraudo³  Luca Vedovelli¹  Francesco Fortarezza¹  Claudia Del Vecchio²  Francesca Lunardi¹  Anna Sara Fraia³  Elisabetta Cocconcelli¹ 

[1] Department of Cardiac, Vascular Sciences, and Public Health, University of Padova, Medical School;Department of Molecular Medicine, University of Padova, Medical School;Department of Medicine, University of Padova, Medical School

关键词: diagnostic yield;    multidisciplinary approach;    COVID-19;    COVID-19 pneumonia;    SARS-CoV-2;   

DOI  :  10.3389/fmed.2021.637872

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose: The hypothesis of the study was that a multidisciplinary approach involving experienced specialists in diffuse parenchymal lung disease might improve the diagnosis of patients with COVID-19 pneumonia. Methods: Two pulmonologists, two radiologists, and two pathologists reviewed 27 patients affected by severe COVID-19 pneumonia as the main diagnosis made by non-pulmonologists. To evaluate whether the contribution of specialists, individually and/or in combination, might modify the original diagnosis, a three-step virtual process was planned. The whole lung examination was considered the gold standard for the final diagnosis. The probability of a correct diagnosis was calculated using a model based on generalized estimating equations. The effectiveness of a multidisciplinary diagnosis was obtained by comparing diagnoses made by experienced pulmonologists with those made by non-pulmonologists. Results: In 19% of cases, the diagnosis of COVID-19-related death was mainly incorrect. The probability of a correct diagnosis increased strikingly from an undedicated clinician to an expert specialist. Every single specialist made significantly more correct diagnoses than any non-pulmonologist. The highest level of accuracy was achieved by the combination of 3 expert specialists ( p = 0.0003). Conclusion: The dynamic interaction between expert specialists may significantly improve the diagnostic confidence and management of patients with COVID-19 pneumonia.

【 授权许可】

CC BY