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Multidisciplinary evaluation of interstitial lung diseases: current insights

机译:间质性肺疾病的多学科评估:最新见解

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Multidisciplinary team (MDT) diagnosis is regarded as the diagnostic reference standard for interstitial lung disease (ILD). Several studies have reported that MDT diagnosis is associated with higher levels of diagnostic confidence and better interobserver agreement when compared to the individual components of the MDT in isolation. Although this recommendation is widely accepted; no guideline statement specifies what constitutes an MDT meeting and how its participants should govern it. Furthermore; the precise role of an MDT meeting in the setting of ILD may vary from one group to another. For example; in some cases; the meeting will confine its discussion to characterising the disease and formulating diagnosis. In others; management decisions may also be part of the discussion. Surprisingly; there is no consensus on how MDT diagnosis is validated. As multidisciplinary evaluation contains all the available clinical information on an individual patient; there is no reference standard against which the veracity of MDT diagnosis can be tested. Finally; many of these uncertainties surrounding MDT meeting practice are unlikely to be answered by traditional evidence-based studies; which create difficulties when generating guideline recommendations. There is clearly a need for expert consensus on what constitutes acceptable MDT meeting practice. This consensus will need to be flexible to accommodate the variability in resources available to fledgling MDT groups and the variable nature of patients requiring discussion.
机译:多学科团队(MDT)的诊断被视为间质性肺病(ILD)的诊断参考标准。几项研究报告说,与单独隔离MDT的各个组件相比,MDT的诊断与更高的诊断置信度和更好的观察者之间的一致性相关。尽管此建议已被广泛接受;没有准则声明指定什么构成了MDT会议及其参与者应如何管理它。此外;在设置ILD的过程中,MDT会议的确切角色可能因一组而异。例如;在某些情况下;会议将讨论仅限于表征疾病和制定诊断。在其他人管理决策也可能是讨论的一部分。出奇;关于如何验证MDT诊断尚无共识。由于多学科评估包含有关单个患者的所有可用临床信息;没有参考标准可以测试MDT诊断的准确性。最后;传统的循证研究不太可能解决围绕MDT会议实践的许多不确定性;在生成指南建议时会遇到困难。显然,需要就什么构成可接受的MDT会议惯例达成专家共识。这种共识将需要灵活一些,以适应刚起步的MDT组可用资源的可变性以及需要讨论的患者的可变性。

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