Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: An international case-cohort study

Simon L.F. Walsh, Toby M. Maher, Martin Kolb, Venerino Poletti, Richard Nusser, Luca Richeldi, Carlo Vancheri, Margaret L. Wilsher, Katerina M. Antoniou, Jüergen Behr, Elisabeth Bendstrup, Kevin Brown, Lucio Calandriello, Tamera J. Corte, Vincent Cottin, Bruno Crestani, Kevin Flaherty, Ian Glaspole, Jan Grutters, Yoshikazu InoueMaria Kokosi, Yasuhiro Kondoh, Vasileios Kouranos, Michael Kreuter, Kerri Johannson, Eoin Judge, Brett Ley, George Margaritopoulos, Fernando J. Martinez, Maria Molina-Molina, António Morais, Hilario Nunes, Ganesh Raghu, Christopher J. Ryerson, Moises Selman, Paolo Spagnolo, Hiroyuki Taniguchi, Sara Tomassetti, Dominique Valeyre, Marlies Wijsenbeek, Wim Wuyts, David Hansell, Athol Wells, P. S. Zhu, Y. Yuan, C. Yoshito Fukuda, Y. Yoshimatsu, A. Xaubet, A. M. Wong, P. White, G. Westney, A. West, T. Wessendorf, Y. Waseda, C. Wang, J. M. Vienna, J. Videnovic Ivanov, V. Vicens Zygmunt, M. C. Venero Caceres, G. Velásquez Pinto, E. Veitch, M. Vasakova, F. Varone, B. E. Varela, P. Van Hal, M. Van De Ven, I. Van Der Lee, L. Van Den Toorn, A. Urrutia Gajate, J. Urban, L. G. Ugarte Fornell, A. Tzouvelekis, K. Twohig, A. Turner, S. Trujillo, A. Triani, D. Traila, V. Torres, H. Tomioka, K. Tomii, R. Tomic, C. Toma, F. Tokgoz Akyil, K. Tobino, R. Tobar, A. Tiwari, R. Tibana, X. Tian, M. Thillai, W. Tham, F. Teo, J. Tekavec Trkanjec, P. Teixeira, D. Tarpey, L. Tapias, K. Tanizawa, Y. Tanino, T. Takada, G. Tabaj, E. Szolnoki, R. Swarnakar, I. Strambu, M. Sterclova, K. Spinks, C. I. Soo, A. Soltani, S. Solanki, E. Sobh, M. R. Soares, J. Smith, B. Smith, P. Slocum, H. Slabbynck, I. Sivokozov, A. Shifren, S. M. Shen, C. Sharp, A. Shanmuganathan, A. Sebastiani, S. Scarlata, R. Savas, S. Sasaki, J. Santeliz, ANC Santana, R. Sanchez, M. Salinas, S. Saito, F. Ryan, J. A. Royo Prats, E. Rosi, H. Rokadia, A. Robles Perez, P. Rivera Ortega, M. Rio Ramirez, S. Righetti, C. Reichner, C. Ravaglia, P. Ratanawatkul, V. Ramalingam, A. Rajasekaran, E. Radzikowska, S. W. Ra, S. Quadrelli, J. Precerutti, J. Prasad, D. Popa, S. Pizzalato, W. Piotrowski, A. Pineiro, D. Piloni, T. Peros Golubicic, R. Perez, C. Pereira, B. Pereira, M. Perch, N. Patel, D. Patel, I. Papanikolaou, D. Papakosta, E. Panselinas, Y. K. Pang, P. Pandya, E. Padrão, O. Ozdemir Kumbasar, M. J. Overbeek, A. Otto Minasian, D. O'Riordan, J. Ora, J. Oldham, O. Okutan, S. Ohshimo, I. K. Oguzulgen, T. Ogura, T. O'Donnell, C. O'Dochartaigh, S. O'Beirne, L. Novikova, L. Novelli, I. Noth, N. Nogueira Mendes Neto, M. Niroumand, A. Nieto, A. Neves, A. Nambiar, S. Nair, R. Nadama, E. Murtagh, M. Mura, J. Müller Quernheim, A. Mukhopadhyay, S. Mukherjee, J. Morisset, O. Moran, J. Mooney, J. Møller, N. Mogulkoc, A. Miyamoto, B. Milenkovic, S. Mette, M. Mejia, F. Mei, M. Mazzei, T. Matsuda, C. Mason, M. Martínez Francés, S. Mannarino, E. Mancuzo, F. Malli, P. Malhotra, M. Maillo, J. Maia, M. Mahdavian, F. Madsen, T. Luckhardt, W. Lucht, S. Y. Low, C. P. Lopez Miguel, R. Lipchik, S. Levy, K. Levin, K. L. Lee, D. Lederer, M. R. Lammi, H. Y. Kwan, S. Kukreja, A. Kruavit, M. Kotecki, L. Kolilekas, H. Knoop, E. Kiyan, T. Kishaba, M. King Biggs, Y. H. Khor, A. Khan, N. Khalil, R. Kedia, N. Kebba, L. Kawano Dourado, K. Kapitan, C. D. Kan, A. F. Kalyoncu, M. Kalluri, Y. Kabasakal, S. Jyothula, M. A. Juretschke, D. Jovanovic, R. Jonkers, H. Jo, S. Izumi, H. Ishii, S. Ikeda, A. Ibrahim, C. Hyldgaard, G. Hunninghake, T. Huie, A. Hufton, X. Hu, W. C. Hseih, R. Hoyos, R. Hoyles, O. Holguin Rodriguez, M. P. Hogan, U. Hodgson, H. Hilkin Sogoloff, E. Herrera, B. M. Henry, M. Hellemons, A. Hecimovic, R. Hayashi, S. Hart, S. Harari, S. Haney, N. Hambly, R. Hakkim, M. Gutiérrez, R. Gripaldo, A. Gomez, N. Goh, R. Godoy, C. Gilbert, I. Giannarakis, S. Gasparini, P. Garcha, S. Furtado, A. Fois, P. Flood Page, S. Fletcher, E. Fiss, J. Figueroa Casas, M. Figueroa Casas, C. A. Fiddler, G. Ferrara, M. Fernandez Casares, C. Felton, P. Faverio, A. T. Fabro, A. Estrada, P. Errhalt, N. Enomoto, J. I. Enghelmayer, K. El Kersh, G. Eiger, A. Dubaniewicz, F. Drakopanagiotakis, S. Disayabutr, A. Dijkstra, J. C. Diaz Patiño, J. J. Diaz Castañon, S. Dhooria, D. J. Dhasmana, M. De Rosa, S. De Luca, A. Delobbe, D. Delgado, C. Delgado, I. De La Fuente, M. De Kruif, M. De Gier, J. De Andrade, J. R. Davidsen, B. Daoud, K. Dalhoff, J. V. Cotera Solano, A. N. Costa, S. Coronel, M. Confalonieri, L. Conemans, A. Comellas, S. Colella, S. Clemente, J. Clark, M. Ciuffreda, C. L. Chung, S. G. Chong, D. Chirita, P. L. Chen, N. Chaudhuri, D. Chambers, G. Chalmers, D. Chairman, G. T. Chai, R. Chacon Chaves, V. Çetinsu, M. Ceruti, C. O. Ceballos Zuñiga, D. Castillo, R. G. Carbone, A. Caminati, F. J. Callejas González, M. Butler, C. Bustos, M. Bukowczan, I. Buendia, G. Brunetti, B. Brockway, P. Bresser, J. Breseghello, D. Bouros, J. A. Botero Zaccour, G. Borzone, R. Borie, H. C. Blum, J. Blank, A. Biswas, D. Bennett, M. Benjamin, I. N. Belaconi, P. Beirne, L. Beckert, S. Bastiampillai, R. Bascom, B. Bartholmai, M. Barros, AYL Ban, E. Balestro, B. Baldi, J. Baddini Martinez, A. Baburao, S. Babu, A. Averyanov, S. Avdeev, R. Athanazio, E. Atahan, B. Asuquo, D. Assayag, J. Antuni, S. Antillon, K. C. Anderson, A. Anderson, F. Alwani, G. Altinisik, N. Alsouofi, J. S. Allam, H. Al Jahdali, A. Al Farttoosi, T. Alfaro, N. Al Busaidi, A. Alavi Foumani, M. G. Agreda Vedia, A. Agarwal, F. Afridi, O. O. Adeyeye, A. Adegunsoye, H. Adamali, A. Abedini

Research output: Contribution to journalArticle

35 Scopus citations

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 (κw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the Cindex. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (κw=0.65, IQR 0.53-0.72, p<0.0001) than academic physicians (κw=0.56, IQR 0.45-0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (κw=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.

Original languageEnglish (US)
Article number1700936
JournalEuropean Respiratory Journal
Volume50
Issue number2
DOIs
StatePublished - Aug 1 2017

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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