Journal article
Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case-cohort study
The European respiratory journal, Vol.50(2), pp.1700936-1700936
08/01/2017
DOI: 10.1183/13993003.00936-2017
PMCID: PMC5593374
PMID: 28860269
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 (kappa w). 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 (kappa w= 0.65, IQR 0.53-0.72, p<0.0001) than academic physicians (kappa w= 0.56, IQR 0.45-0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (kappa w=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.
Details
- Title: Subtitle
- Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case-cohort study
- Creators
- Simon L. F. Walsh - King's College HospitalToby M. Maher - Royal Brompton HospitalMartin Kolb - McMaster UniversityVenerino Poletti - Aarhus University HospitalRichard Nusser - SummitLuca Richeldi - Università Cattolica del Sacro CuoreCarlo Vancheri - University of CataniaMargaret L. Wilsher - University of AucklandKaterina M. Antoniou - University of CreteJuergen Behr - Asklepios Fachkliniken München-GautingElisabeth Bendstrup - Aarhus University HospitalKevin Brown - National Jewish HealthLucio Calandriello - Università Cattolica del Sacro CuoreTamera J. Corte - Royal Prince Alfred HospitalVincent Cottin - Hôpital Louis PradelBruno Crestani - Délégation Paris 7Kevin Flaherty - University of Michigan–Ann ArborIan Glaspole - Alfred HealthJan Grutters - University Medical Center UtrechtYoshikazu Inoue - National Hospital OrganizationMaria Kokosi - Royal Brompton HospitalYasuhiro Kondoh - Tosei General HospitalVasileios Kouranos - Royal Brompton HospitalMichael Kreuter - Heidelberg UniversityKerri Johannson - University of CalgaryEoin Judge - Mater Misericordiae University HospitalBrett Ley - University of California, San FranciscoGeorge Margaritopoulos - Royal Brompton HospitalFernando J. Martinez - Weill Cornell MedicineMaria Molina-Molina - Bellvitge University HospitalAntonio Morais - Hospital de São JoãoHilario Nunes - Université Sorbonne Paris NordGanesh Raghu - University of WashingtonChristopher J. Ryerson - University of British ColumbiaMoises Selman - Instituto Nacional de Enfermedades RespiratoriasPaolo Spagnolo - University of PaduaHiroyuki Taniguchi - Tosei General HospitalSara Tomassetti - Ospedale MaggioreDominique Valeyre - Université Sorbonne Paris NordMarlies Wijsenbeek - Dept of Pulmonary Diseases, Erasmus MC, University Hospital Rotterdam, Rotterdam, The Netherlands.Wim Wuyts - KU LeuvenDavid Hansell - Royal Brompton HospitalAthol Wells - Royal Brompton HospitalIPF Project Consortium
- Contributors
- Alejandro Comellas (Contributor) - University of Iowa, Pulmonary, Critical Care, and Occupational Medicine
- Resource Type
- Journal article
- Publication Details
- The European respiratory journal, Vol.50(2), pp.1700936-1700936
- Publisher
- European Respiratory Soc Journals Ltd
- DOI
- 10.1183/13993003.00936-2017
- PMID
- 28860269
- PMCID
- PMC5593374
- ISSN
- 0903-1936
- eISSN
- 1399-3003
- Number of pages
- 10
- Grant note
- P30 GM106392 / NIGMS NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS) P30GM106392 / NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS)
- Language
- English
- Date published
- 08/01/2017
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984359829502771
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