Multidisciplinary Evaluation of Interstitial Lung Diseases: New Opportunities Linked to Rheumatologist Involvement

Diagnostics

AnnaRita Larici¹  Lucio Calandriello¹  Giuseppe Cicchetti¹  SilviaLaura Bosello²  Lucrezia Verardi³  Laura Gigante³  Elisa Gremese³  Enrico De Lorenzis³  Gerlando Natalello³  Giacomo Sgalla⁴  Bruno Iovene⁴  Luca Richeldi⁴  Francesco Varone⁴ 

[1] Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;Divisione di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;Institute of Rheumatology, Catholic University of the Sacred Heart, 00168 Rome, Italy;UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;

关键词: interstitial lung disease;    systemic rheumatic autoimmune disease;    connective tissue disease;    rheumatoid arthritis;    interstitial pneumonia with autoimmune features;    multidisciplinary team;   

DOI  :  10.3390/diagnostics10090664

来源: DOAJ

【 摘 要 】

Multidisciplinary team (MDT) discussion is the gold standard in the management of interstitial lung disease (ILD). The rheumatologist is not routinely involved in MDT, even if up to 20% of ILD are related to systemic autoimmune rheumatic diseases (SARD). The study aims to assess the agreement and its variation over time between rheumatologists and pulmonologists in the screening of SARD and between rheumatologists and an MDT extended to rheumatologists (eMDT) in evaluating the progression of SARD. We computed the agreement between the pulmonologist and rheumatologist in the identification of red flags for SARDs of 81 ILD cases and between the rheumatologist alone and eMDT in the confirmation of 70 suspected SARD-ILD progressions. The agreement between rheumatologists and pulmonologists was moderate for the detection of autoimmunity test positivity (κ = 0.475, p < 0.001) and family history of SARD (κ = 0.491, p < 0.001) and fair for the identification of extrapulmonary symptoms (κ = 0.225, p = 0.064) or routine laboratory abnormalities consistent with SARD. The average agreement between the rheumatologist and eMDT in the identification of ILD progression was moderate (κ = 0.436, p < 0.001). The class of agreement improved from the first to the third semester. The average agreement with the rheumatologist ranged from fair to moderate, suggesting that a shared evaluation of SARD-ILD in eMDT could improve the diagnostic work-up and the evaluation of ILD progression.

【 授权许可】

Unknown