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									<identifier>oai:www.peertechzpublications.org:10.17352/aprc.000005</identifier>
									<datestamp>2015-11-09</datestamp>
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										<dc:title>
										A Review of the Multidisciplinary  Diagnosis of Interstitial Lung  Diseases: A Retrospective Analysis in  a Single UK Specialist Centre
										</dc:title><dc:creator>Nazia Chaudhuri</dc:creator><dc:creator> Lisa Spencer</dc:creator><dc:creator> Colm leonard</dc:creator><dc:description>&lt;p&gt;A multidisciplinary team approach to diagnosis and management of interstitial lung diseases (ILD) is&amp;nbsp; considered&amp;nbsp; gold&amp;nbsp; standard&amp;nbsp; and&amp;nbsp; an&amp;nbsp; integral&amp;nbsp; part&amp;nbsp; of&amp;nbsp; ILD&amp;nbsp; management&amp;nbsp; and&amp;nbsp; guidelines.The&amp;nbsp; accurate diagnosis and management of individuals with ILDs poses an interesting challenge in clinical practice. This&amp;nbsp; is&amp;nbsp; a&amp;nbsp; single&amp;nbsp; center&amp;nbsp; retrospective review&amp;nbsp; of&amp;nbsp; electronic&amp;nbsp; patient&amp;nbsp; letters&amp;nbsp; and&amp;nbsp; multidisciplinary&amp;nbsp; team (MDT) records spanning a five and half year time period. In this study we assessed the accuracy of prior ILD diagnosis, the methodology used to establish a correct diagnosis and how an MDT approach to diagnosis affected subsequent management.&lt;/p&gt;&lt;p&gt;Our results demonstrate that a multidisciplinary approach to diagnosis within a single specialist ILD center can establish a diagnosis in the majority of cases when prior diagnosis is uncertain (76%). We&amp;nbsp; also&amp;nbsp; show&amp;nbsp; that&amp;nbsp; a&amp;nbsp; prior&amp;nbsp; diagnosis&amp;nbsp; of&amp;nbsp; idiopathic&amp;nbsp; pulmonary&amp;nbsp; fibrosis&amp;nbsp; is&amp;nbsp; deemed&amp;nbsp; inaccurate&amp;nbsp; in&amp;nbsp; over fifty percent of cases after MDT discussion. Other ILD diagnoses fair better with an inaccurate prior diagnosis&amp;nbsp; in&amp;nbsp; a&amp;nbsp; third&amp;nbsp; of&amp;nbsp; cases.&amp;nbsp; Over&amp;nbsp; time&amp;nbsp; we&amp;nbsp; demonstrate&amp;nbsp; an&amp;nbsp; increased&amp;nbsp; utilisation&amp;nbsp; of&amp;nbsp; combined&amp;nbsp; lung biopsy&amp;nbsp; and&amp;nbsp; radiological&amp;nbsp; imaging&amp;nbsp; to&amp;nbsp; establish&amp;nbsp; a&amp;nbsp; diagnosis.&amp;nbsp; However&amp;nbsp; when&amp;nbsp; diagnosis&amp;nbsp; was&amp;nbsp; deemed uncertain on radiological imaging alone, biopsy was seldom possible due to factors such as poor lung function or presence of comorbidities deeming biopsy as too high risk.&lt;/p&gt;&lt;p&gt;Our&amp;nbsp; data&amp;nbsp; supports&amp;nbsp; an&amp;nbsp; MDT&amp;nbsp; approach&amp;nbsp; in&amp;nbsp; an&amp;nbsp; experienced&amp;nbsp; specialised&amp;nbsp; ILD&amp;nbsp; center.&amp;nbsp; We&amp;nbsp; have demonstrated that diagnosis is often changed after an MDT review and that this impacts on subsequent management.&amp;nbsp; We&amp;nbsp; have&amp;nbsp; shown&amp;nbsp; that&amp;nbsp; during&amp;nbsp; diagnostic&amp;nbsp; uncertainty&amp;nbsp; the&amp;nbsp; considered&amp;nbsp; gold&amp;nbsp; standard&amp;nbsp; of proceeding to a lung biopsy is not always feasible due to disease severity and comorbidities. In these circumstances an MDT approach to diagnosis of ILDs combines clinical data with serial lung function and disease behavior, with or without responses to previous treatment trials to establish an accurate expert diagnosis.&lt;/p&gt;</dc:description>
										<dc:publisher>Archives of Pulmonology and Respiratory Care - Peertechz Publications</dc:publisher>
										<dc:date>2015-11-09</dc:date>
										<dc:type>Review Article</dc:type>
										<dc:identifier>https://doi.org/10.17352/aprc.000005</dc:identifier>
										<dc:language>en</dc:language>
										<dc:rights>Copyright © Nazia Chaudhuri et al.</dc:rights>
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