Lessons learned from 4 years Multidisciplinary discussion (MDD) in interstitial lung diseases (ILD)

Abstract

ILD`s describe a heterogeneous collection of lung disorders. MDD has become a gold standard in the differential diagnosis of ILDs. The aim of this retrospetive data analysis was to figure out in how many patients MDD was able to establish a final diagnosis and in how many patients no clear diagnosis could be obtained. This is a single-centre retrospective data-analysis of patients presented to the MDD of a tertiary Pulmonary hospital between January and December 2019. Patients with suspected ILD`s were referred to the department either from other hospitals or outpatient clinics. Criteria for inclusion were availability of a MDD report, radiological images and histopathology report (if available). MDD consists of at least three pulmonologists, one thoracic radiologist and one thoracic histopathologist. 314 patients were discussed within 4 years. 224 patients (71%) received a definite diagnosis. 90 Patients (29%) received further recommendations. 18 % (55 patients) from 314 patients received a suspected diagnosis with a recommendation for further procedures. 35 patients (11%) from the 314 patients were seen as unclassified and received further recommendations. The most frequent diagnoses were Idiopathic pulmonary fibrosis (IPF) and Sarcoidosis. 44 patients were discussed more than once. 16 of those 44 patients received a definite diagnosis either after the 2nd MDD (13 patients), the 3rd MDD (1 patient) or the 5th MDD (2 patients). 8 of those 44 patients remained without a definite diagnosis even after multiple MDD introductions. Most of the patients discussed in the MDD received a definitive diagnosis. Only a few patients were seen as unclassificable after multiple MDD introductions.