Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case–cohort study
Identifieur interne : 004D75 ( Ncbi/Curation ); précédent : 004D74; suivant : 004D76Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case–cohort study
Auteurs : Simon L. F. Walsh [Royaume-Uni] ; Toby M. Maher [Royaume-Uni] ; Martin Kolb [Canada] ; Venerino Poletti [Italie, Danemark] ; Richard Nusser [États-Unis] ; Luca Richeldi [Italie] ; Carlo Vancheri [Italie] ; Margaret L. Wilsher [Nouvelle-Zélande] ; Katerina M. Antoniou [Grèce] ; Jüergen Behr [Allemagne] ; Elisabeth Bendstrup [Danemark] ; Kevin Brown [États-Unis] ; Lucio Calandriello [Italie] ; Tamera J. Corte [Australie] ; Vincent Cottin [France] ; Bruno Crestani [France] ; Kevin Flaherty [États-Unis] ; Ian Glaspole [Australie] ; Jan Grutters [Pays-Bas] ; Yoshikazu Inoue [Japon] ; Maria Kokosi [Royaume-Uni] ; Yasuhiro Kondoh [Japon] ; Vasileios Kouranos [Royaume-Uni] ; Michael Kreuter [Allemagne] ; Kerri Johannson [Canada] ; Eoin Judge [Irlande (pays)] ; Brett Ley [États-Unis] ; George Margaritopoulos [Royaume-Uni] ; Fernando J. Martinez [États-Unis] ; Maria Molina-Molina [Espagne] ; Ant Nio Morais [Portugal] ; Hilario Nunes [France] ; Ganesh Raghu [États-Unis] ; Christopher J. Ryerson [Canada] ; Moises Selman [Mexique] ; Paolo Spagnolo [Italie] ; Hiroyuki Taniguchi [Japon] ; Sara Tomassetti [Italie] ; Dominique Valeyre [France] ; Marlies Wijsenbeek [Pays-Bas] ; Wim Wuyts [Belgique] ; David Hansell [Royaume-Uni] ; Athol Wells [Royaume-Uni]Source :
- The European Respiratory Journal [ 0903-1936 ] ; 2017.
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 C-index.
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.
Url:
DOI: 10.1183/13993003.00936-2017
PubMed: 28860269
PubMed Central: 5593374
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<author><name sortKey="Maher, Toby M" sort="Maher, Toby M" uniqKey="Maher T" first="Toby M." last="Maher">Toby M. Maher</name>
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<author><name sortKey="Poletti, Venerino" sort="Poletti, Venerino" uniqKey="Poletti V" first="Venerino" last="Poletti">Venerino Poletti</name>
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<author><name sortKey="Nusser, Richard" sort="Nusser, Richard" uniqKey="Nusser R" first="Richard" last="Nusser">Richard Nusser</name>
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<author><name sortKey="Richeldi, Luca" sort="Richeldi, Luca" uniqKey="Richeldi L" first="Luca" last="Richeldi">Luca Richeldi</name>
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<author><name sortKey="Vancheri, Carlo" sort="Vancheri, Carlo" uniqKey="Vancheri C" first="Carlo" last="Vancheri">Carlo Vancheri</name>
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<author><name sortKey="Wilsher, Margaret L" sort="Wilsher, Margaret L" uniqKey="Wilsher M" first="Margaret L." last="Wilsher">Margaret L. Wilsher</name>
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<author><name sortKey="Antoniou, Katerina M" sort="Antoniou, Katerina M" uniqKey="Antoniou K" first="Katerina M." last="Antoniou">Katerina M. Antoniou</name>
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<author><name sortKey="Behr, Juergen" sort="Behr, Juergen" uniqKey="Behr J" first="Jüergen" last="Behr">Jüergen Behr</name>
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<author><name sortKey="Bendstrup, Elisabeth" sort="Bendstrup, Elisabeth" uniqKey="Bendstrup E" first="Elisabeth" last="Bendstrup">Elisabeth Bendstrup</name>
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<author><name sortKey="Brown, Kevin" sort="Brown, Kevin" uniqKey="Brown K" first="Kevin" last="Brown">Kevin Brown</name>
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<author><name sortKey="Calandriello, Lucio" sort="Calandriello, Lucio" uniqKey="Calandriello L" first="Lucio" last="Calandriello">Lucio Calandriello</name>
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<author><name sortKey="Corte, Tamera J" sort="Corte, Tamera J" uniqKey="Corte T" first="Tamera J." last="Corte">Tamera J. Corte</name>
<affiliation wicri:level="4"><nlm:aff id="af14">Dept of Respiratory Medicine, Royal Prince Alfred Hospital, and University of Sydney, Sydney, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Dept of Respiratory Medicine, Royal Prince Alfred Hospital, and University of Sydney, Sydney</wicri:regionArea>
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<author><name sortKey="Cottin, Vincent" sort="Cottin, Vincent" uniqKey="Cottin V" first="Vincent" last="Cottin">Vincent Cottin</name>
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<author><name sortKey="Crestani, Bruno" sort="Crestani, Bruno" uniqKey="Crestani B" first="Bruno" last="Crestani">Bruno Crestani</name>
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<author><name sortKey="Flaherty, Kevin" sort="Flaherty, Kevin" uniqKey="Flaherty K" first="Kevin" last="Flaherty">Kevin Flaherty</name>
<affiliation wicri:level="2"><nlm:aff id="af17">University of Michigan, Division of Pulmonary and Critical Care Medicine, Ann Arbor, MI, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Michigan, Division of Pulmonary and Critical Care Medicine, Ann Arbor, MI</wicri:regionArea>
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</placeName>
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<author><name sortKey="Glaspole, Ian" sort="Glaspole, Ian" uniqKey="Glaspole I" first="Ian" last="Glaspole">Ian Glaspole</name>
<affiliation wicri:level="3"><nlm:aff id="af18">Alfred Health - Allergy, Immunology and Respiratory Medicine, Melbourne, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Alfred Health - Allergy, Immunology and Respiratory Medicine, Melbourne</wicri:regionArea>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Grutters, Jan" sort="Grutters, Jan" uniqKey="Grutters J" first="Jan" last="Grutters">Jan Grutters</name>
<affiliation wicri:level="3"><nlm:aff id="af19">ILD Center of Excellence, St Antonius Hospital, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>ILD Center of Excellence, St Antonius Hospital, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht</wicri:regionArea>
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<author><name sortKey="Inoue, Yoshikazu" sort="Inoue, Yoshikazu" uniqKey="Inoue Y" first="Yoshikazu" last="Inoue">Yoshikazu Inoue</name>
<affiliation wicri:level="1"><nlm:aff id="af20">Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka</wicri:regionArea>
<wicri:noRegion>Osaka</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kokosi, Maria" sort="Kokosi, Maria" uniqKey="Kokosi M" first="Maria" last="Kokosi">Maria Kokosi</name>
<affiliation wicri:level="3"><nlm:aff id="af21">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kondoh, Yasuhiro" sort="Kondoh, Yasuhiro" uniqKey="Kondoh Y" first="Yasuhiro" last="Kondoh">Yasuhiro Kondoh</name>
<affiliation wicri:level="1"><nlm:aff id="af22">Tosei General Hospital, Dept of Respiratory Medicine and Allergy, Seto, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Tosei General Hospital, Dept of Respiratory Medicine and Allergy, Seto</wicri:regionArea>
<wicri:noRegion>Seto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kouranos, Vasileios" sort="Kouranos, Vasileios" uniqKey="Kouranos V" first="Vasileios" last="Kouranos">Vasileios Kouranos</name>
<affiliation wicri:level="3"><nlm:aff id="af21">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kreuter, Michael" sort="Kreuter, Michael" uniqKey="Kreuter M" first="Michael" last="Kreuter">Michael Kreuter</name>
<affiliation wicri:level="3"><nlm:aff id="af23">Center for interstitial and rare lung diseases, Pneumology and respiratory critical care medicine, Thoraxklinik, University of Heidelberg, and Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Center for interstitial and rare lung diseases, Pneumology and respiratory critical care medicine, Thoraxklinik, University of Heidelberg, and Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg</wicri:regionArea>
<placeName><region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Karlsruhe</region>
<settlement type="city">Heidelberg</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Johannson, Kerri" sort="Johannson, Kerri" uniqKey="Johannson K" first="Kerri" last="Johannson">Kerri Johannson</name>
<affiliation wicri:level="4"><nlm:aff id="af24">University Of Calgary, Calgary, AB, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University Of Calgary, Calgary, AB</wicri:regionArea>
<orgName type="university">Université de Calgary</orgName>
<placeName><settlement type="city">Calgary</settlement>
<region type="state">Alberta</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Judge, Eoin" sort="Judge, Eoin" uniqKey="Judge E" first="Eoin" last="Judge">Eoin Judge</name>
<affiliation wicri:level="1"><nlm:aff id="af25">Respiratory Medicine and National Lung Transplantation Unit, Mater Misericordiae University Hospital, Dublin , Ireland</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Respiratory Medicine and National Lung Transplantation Unit, Mater Misericordiae University Hospital, Dublin </wicri:regionArea>
<wicri:noRegion>Dublin </wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ley, Brett" sort="Ley, Brett" uniqKey="Ley B" first="Brett" last="Ley">Brett Ley</name>
<affiliation wicri:level="2"><nlm:aff id="af26">Medicine, University of California San Francisco, San Francisco, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Medicine, University of California San Francisco, San Francisco, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Margaritopoulos, George" sort="Margaritopoulos, George" uniqKey="Margaritopoulos G" first="George" last="Margaritopoulos">George Margaritopoulos</name>
<affiliation wicri:level="3"><nlm:aff id="af21">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Martinez, Fernando J" sort="Martinez, Fernando J" uniqKey="Martinez F" first="Fernando J." last="Martinez">Fernando J. Martinez</name>
<affiliation wicri:level="2"><nlm:aff id="af27">Weill Cornell Medicine, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Weill Cornell Medicine, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Molina Molina, Maria" sort="Molina Molina, Maria" uniqKey="Molina Molina M" first="Maria" last="Molina-Molina">Maria Molina-Molina</name>
<affiliation wicri:level="3"><nlm:aff id="af28">University Hospital of Bellvitge-IDIBELL-CIBERES, Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>University Hospital of Bellvitge-IDIBELL-CIBERES, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Morais, Ant Nio" sort="Morais, Ant Nio" uniqKey="Morais A" first="Ant Nio" last="Morais">Ant Nio Morais</name>
<affiliation wicri:level="1"><nlm:aff id="af29">Centro Hospitalar São João – Pulmonology, Faculdade de Medicina do Porto, Alameda Professor Hernâni Monteiro, Oporto, Portugal</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea>Centro Hospitalar São João – Pulmonology, Faculdade de Medicina do Porto, Alameda Professor Hernâni Monteiro, Oporto</wicri:regionArea>
<wicri:noRegion>Oporto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nunes, Hilario" sort="Nunes, Hilario" uniqKey="Nunes H" first="Hilario" last="Nunes">Hilario Nunes</name>
<affiliation wicri:level="3"><nlm:aff id="af30">Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Bobigny</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Raghu, Ganesh" sort="Raghu, Ganesh" uniqKey="Raghu G" first="Ganesh" last="Raghu">Ganesh Raghu</name>
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<author><name sortKey="Selman, Moises" sort="Selman, Moises" uniqKey="Selman M" first="Moises" last="Selman">Moises Selman</name>
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<affiliation wicri:level="1"><nlm:aff id="af34">Section of Respiratory Diseases, Dept of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy</nlm:aff>
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<affiliation wicri:level="1"><nlm:aff id="af4">Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy</nlm:aff>
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<wicri:regionArea>Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì</wicri:regionArea>
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<author><name sortKey="Valeyre, Dominique" sort="Valeyre, Dominique" uniqKey="Valeyre D" first="Dominique" last="Valeyre">Dominique Valeyre</name>
<affiliation wicri:level="3"><nlm:aff id="af30">Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny, France</nlm:aff>
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<author><name sortKey="Wijsenbeek, Marlies" sort="Wijsenbeek, Marlies" uniqKey="Wijsenbeek M" first="Marlies" last="Wijsenbeek">Marlies Wijsenbeek</name>
<affiliation wicri:level="3"><nlm:aff id="af35">Dept of Pulmonary Diseases, Erasmus MC, University Hospital Rotterdam, Rotterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
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<author><name sortKey="Hansell, David" sort="Hansell, David" uniqKey="Hansell D" first="David" last="Hansell">David Hansell</name>
<affiliation wicri:level="3"><nlm:aff id="af37">Dept of Thoracic Imaging, Royal Brompton Hospital, London, UK</nlm:aff>
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<wicri:regionArea>Dept of Thoracic Imaging, Royal Brompton Hospital, London</wicri:regionArea>
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</placeName>
</affiliation>
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<author><name sortKey="Wells, Athol" sort="Wells, Athol" uniqKey="Wells A" first="Athol" last="Wells">Athol Wells</name>
<affiliation wicri:level="3"><nlm:aff id="af38">Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
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<wicri:regionArea>Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case–cohort study</title>
<author><name sortKey="Walsh, Simon L F" sort="Walsh, Simon L F" uniqKey="Walsh S" first="Simon L. F." last="Walsh">Simon L. F. Walsh</name>
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<wicri:regionArea>Dept of Radiology, King's College Hospital Foundation Trust, London</wicri:regionArea>
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<author><name sortKey="Maher, Toby M" sort="Maher, Toby M" uniqKey="Maher T" first="Toby M." last="Maher">Toby M. Maher</name>
<affiliation wicri:level="3"><nlm:aff id="af2">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London</wicri:regionArea>
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<author><name sortKey="Kolb, Martin" sort="Kolb, Martin" uniqKey="Kolb M" first="Martin" last="Kolb">Martin Kolb</name>
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<wicri:regionArea>Depts of Medicine and Pathology/Molecular Medicine, McMaster University, Firestone Institute for Respiratory Health, Hamilton, ON</wicri:regionArea>
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<author><name sortKey="Poletti, Venerino" sort="Poletti, Venerino" uniqKey="Poletti V" first="Venerino" last="Poletti">Venerino Poletti</name>
<affiliation wicri:level="1"><nlm:aff id="af4">Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:aff id="af5">Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus</wicri:regionArea>
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<author><name sortKey="Nusser, Richard" sort="Nusser, Richard" uniqKey="Nusser R" first="Richard" last="Nusser">Richard Nusser</name>
<affiliation wicri:level="2"><nlm:aff id="af6">Dept of Respiratory Medicine, Summit Hospital, Oakland, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Dept of Respiratory Medicine, Summit Hospital, Oakland, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
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</affiliation>
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<author><name sortKey="Richeldi, Luca" sort="Richeldi, Luca" uniqKey="Richeldi L" first="Luca" last="Richeldi">Luca Richeldi</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Unità Operativa Complessa di Pneumologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome</wicri:regionArea>
<placeName><settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vancheri, Carlo" sort="Vancheri, Carlo" uniqKey="Vancheri C" first="Carlo" last="Vancheri">Carlo Vancheri</name>
<affiliation wicri:level="1"><nlm:aff id="af8">Dept of Clinical and Experimental Medicine, University of Catania, University - Hospital “Policlinico - Vitt. Emanuele”, Catania, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Dept of Clinical and Experimental Medicine, University of Catania, University - Hospital “Policlinico - Vitt. Emanuele”, Catania</wicri:regionArea>
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<author><name sortKey="Wilsher, Margaret L" sort="Wilsher, Margaret L" uniqKey="Wilsher M" first="Margaret L." last="Wilsher">Margaret L. Wilsher</name>
<affiliation wicri:level="1"><nlm:aff id="af9">Auckland District Health Board and the University of Auckland, Auckland, New Zealand</nlm:aff>
<country xml:lang="fr">Nouvelle-Zélande</country>
<wicri:regionArea>Auckland District Health Board and the University of Auckland, Auckland</wicri:regionArea>
<wicri:noRegion>Auckland</wicri:noRegion>
</affiliation>
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<author><name sortKey="Antoniou, Katerina M" sort="Antoniou, Katerina M" uniqKey="Antoniou K" first="Katerina M." last="Antoniou">Katerina M. Antoniou</name>
<affiliation wicri:level="1"><nlm:aff id="af10">Dept of Respiratory Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>Dept of Respiratory Medicine, Faculty of Medicine, University of Crete, Heraklion</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Behr, Juergen" sort="Behr, Juergen" uniqKey="Behr J" first="Jüergen" last="Behr">Jüergen Behr</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Dept of Medicine V, University of Munich and Asklepios Fachkliniken Gauting, Comprehensive Pneumology Center, member of the German Center for Lung Research, Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
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<settlement type="city">Munich</settlement>
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<author><name sortKey="Bendstrup, Elisabeth" sort="Bendstrup, Elisabeth" uniqKey="Bendstrup E" first="Elisabeth" last="Bendstrup">Elisabeth Bendstrup</name>
<affiliation wicri:level="1"><nlm:aff id="af5">Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus</wicri:regionArea>
<wicri:noRegion>Aarhus</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Brown, Kevin" sort="Brown, Kevin" uniqKey="Brown K" first="Kevin" last="Brown">Kevin Brown</name>
<affiliation wicri:level="2"><nlm:aff id="af12">National Jewish Health, Denver, CO, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>National Jewish Health, Denver, CO</wicri:regionArea>
<placeName><region type="state">Colorado</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Calandriello, Lucio" sort="Calandriello, Lucio" uniqKey="Calandriello L" first="Lucio" last="Calandriello">Lucio Calandriello</name>
<affiliation wicri:level="3"><nlm:aff id="af13">Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, Rome</wicri:regionArea>
<placeName><settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Corte, Tamera J" sort="Corte, Tamera J" uniqKey="Corte T" first="Tamera J." last="Corte">Tamera J. Corte</name>
<affiliation wicri:level="4"><nlm:aff id="af14">Dept of Respiratory Medicine, Royal Prince Alfred Hospital, and University of Sydney, Sydney, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Dept of Respiratory Medicine, Royal Prince Alfred Hospital, and University of Sydney, Sydney</wicri:regionArea>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
<settlement type="city">Sydney</settlement>
</placeName>
<orgName type="university">Université de Sydney</orgName>
</affiliation>
</author>
<author><name sortKey="Cottin, Vincent" sort="Cottin, Vincent" uniqKey="Cottin V" first="Vincent" last="Cottin">Vincent Cottin</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Pneumologie, Hopital L. Pradel, Lyon</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Crestani, Bruno" sort="Crestani, Bruno" uniqKey="Crestani B" first="Bruno" last="Crestani">Bruno Crestani</name>
<affiliation wicri:level="3"><nlm:aff id="af16">APHP, Hopital Bichat, Service de Pneumologie A, Université Paris Diderot, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>APHP, Hopital Bichat, Service de Pneumologie A, Université Paris Diderot, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Flaherty, Kevin" sort="Flaherty, Kevin" uniqKey="Flaherty K" first="Kevin" last="Flaherty">Kevin Flaherty</name>
<affiliation wicri:level="2"><nlm:aff id="af17">University of Michigan, Division of Pulmonary and Critical Care Medicine, Ann Arbor, MI, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Michigan, Division of Pulmonary and Critical Care Medicine, Ann Arbor, MI</wicri:regionArea>
<placeName><region type="state">Michigan</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Glaspole, Ian" sort="Glaspole, Ian" uniqKey="Glaspole I" first="Ian" last="Glaspole">Ian Glaspole</name>
<affiliation wicri:level="3"><nlm:aff id="af18">Alfred Health - Allergy, Immunology and Respiratory Medicine, Melbourne, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Alfred Health - Allergy, Immunology and Respiratory Medicine, Melbourne</wicri:regionArea>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Grutters, Jan" sort="Grutters, Jan" uniqKey="Grutters J" first="Jan" last="Grutters">Jan Grutters</name>
<affiliation wicri:level="3"><nlm:aff id="af19">ILD Center of Excellence, St Antonius Hospital, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>ILD Center of Excellence, St Antonius Hospital, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht</wicri:regionArea>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Inoue, Yoshikazu" sort="Inoue, Yoshikazu" uniqKey="Inoue Y" first="Yoshikazu" last="Inoue">Yoshikazu Inoue</name>
<affiliation wicri:level="1"><nlm:aff id="af20">Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Kokosi, Maria" sort="Kokosi, Maria" uniqKey="Kokosi M" first="Maria" last="Kokosi">Maria Kokosi</name>
<affiliation wicri:level="3"><nlm:aff id="af21">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kondoh, Yasuhiro" sort="Kondoh, Yasuhiro" uniqKey="Kondoh Y" first="Yasuhiro" last="Kondoh">Yasuhiro Kondoh</name>
<affiliation wicri:level="1"><nlm:aff id="af22">Tosei General Hospital, Dept of Respiratory Medicine and Allergy, Seto, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Tosei General Hospital, Dept of Respiratory Medicine and Allergy, Seto</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Kouranos, Vasileios" sort="Kouranos, Vasileios" uniqKey="Kouranos V" first="Vasileios" last="Kouranos">Vasileios Kouranos</name>
<affiliation wicri:level="3"><nlm:aff id="af21">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kreuter, Michael" sort="Kreuter, Michael" uniqKey="Kreuter M" first="Michael" last="Kreuter">Michael Kreuter</name>
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</affiliation>
</author>
<author><name sortKey="Johannson, Kerri" sort="Johannson, Kerri" uniqKey="Johannson K" first="Kerri" last="Johannson">Kerri Johannson</name>
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<placeName><settlement type="city">Calgary</settlement>
<region type="state">Alberta</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Judge, Eoin" sort="Judge, Eoin" uniqKey="Judge E" first="Eoin" last="Judge">Eoin Judge</name>
<affiliation wicri:level="1"><nlm:aff id="af25">Respiratory Medicine and National Lung Transplantation Unit, Mater Misericordiae University Hospital, Dublin , Ireland</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Respiratory Medicine and National Lung Transplantation Unit, Mater Misericordiae University Hospital, Dublin </wicri:regionArea>
<wicri:noRegion>Dublin </wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ley, Brett" sort="Ley, Brett" uniqKey="Ley B" first="Brett" last="Ley">Brett Ley</name>
<affiliation wicri:level="2"><nlm:aff id="af26">Medicine, University of California San Francisco, San Francisco, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Medicine, University of California San Francisco, San Francisco, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Margaritopoulos, George" sort="Margaritopoulos, George" uniqKey="Margaritopoulos G" first="George" last="Margaritopoulos">George Margaritopoulos</name>
<affiliation wicri:level="3"><nlm:aff id="af21">Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Martinez, Fernando J" sort="Martinez, Fernando J" uniqKey="Martinez F" first="Fernando J." last="Martinez">Fernando J. Martinez</name>
<affiliation wicri:level="2"><nlm:aff id="af27">Weill Cornell Medicine, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Weill Cornell Medicine, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Molina Molina, Maria" sort="Molina Molina, Maria" uniqKey="Molina Molina M" first="Maria" last="Molina-Molina">Maria Molina-Molina</name>
<affiliation wicri:level="3"><nlm:aff id="af28">University Hospital of Bellvitge-IDIBELL-CIBERES, Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>University Hospital of Bellvitge-IDIBELL-CIBERES, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Morais, Ant Nio" sort="Morais, Ant Nio" uniqKey="Morais A" first="Ant Nio" last="Morais">Ant Nio Morais</name>
<affiliation wicri:level="1"><nlm:aff id="af29">Centro Hospitalar São João – Pulmonology, Faculdade de Medicina do Porto, Alameda Professor Hernâni Monteiro, Oporto, Portugal</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea>Centro Hospitalar São João – Pulmonology, Faculdade de Medicina do Porto, Alameda Professor Hernâni Monteiro, Oporto</wicri:regionArea>
<wicri:noRegion>Oporto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nunes, Hilario" sort="Nunes, Hilario" uniqKey="Nunes H" first="Hilario" last="Nunes">Hilario Nunes</name>
<affiliation wicri:level="3"><nlm:aff id="af30">Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Bobigny</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Raghu, Ganesh" sort="Raghu, Ganesh" uniqKey="Raghu G" first="Ganesh" last="Raghu">Ganesh Raghu</name>
<affiliation wicri:level="2"><nlm:aff id="af31">University of Washington - Center for Interstitial Lung Disease, Seattle, WA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Washington - Center for Interstitial Lung Disease, Seattle, WA</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ryerson, Christopher J" sort="Ryerson, Christopher J" uniqKey="Ryerson C" first="Christopher J." last="Ryerson">Christopher J. Ryerson</name>
<affiliation wicri:level="1"><nlm:aff id="af32">University of British Columbia – Medicine, Vancouver, BC, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of British Columbia – Medicine, Vancouver, BC</wicri:regionArea>
<wicri:noRegion>BC</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Selman, Moises" sort="Selman, Moises" uniqKey="Selman M" first="Moises" last="Selman">Moises Selman</name>
<affiliation wicri:level="1"><nlm:aff id="af33">Instituto Nacional de Enfermedades Respiratorias “Ismael Cosio Villegas”, Mexico City, Mexico</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea>Instituto Nacional de Enfermedades Respiratorias “Ismael Cosio Villegas”, Mexico City</wicri:regionArea>
<wicri:noRegion>Mexico City</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Spagnolo, Paolo" sort="Spagnolo, Paolo" uniqKey="Spagnolo P" first="Paolo" last="Spagnolo">Paolo Spagnolo</name>
<affiliation wicri:level="1"><nlm:aff id="af34">Section of Respiratory Diseases, Dept of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Section of Respiratory Diseases, Dept of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova</wicri:regionArea>
<wicri:noRegion>Padova</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Taniguchi, Hiroyuki" sort="Taniguchi, Hiroyuki" uniqKey="Taniguchi H" first="Hiroyuki" last="Taniguchi">Hiroyuki Taniguchi</name>
<affiliation wicri:level="1"><nlm:aff id="af22">Tosei General Hospital, Dept of Respiratory Medicine and Allergy, Seto, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Tosei General Hospital, Dept of Respiratory Medicine and Allergy, Seto</wicri:regionArea>
<wicri:noRegion>Seto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Tomassetti, Sara" sort="Tomassetti, Sara" uniqKey="Tomassetti S" first="Sara" last="Tomassetti">Sara Tomassetti</name>
<affiliation wicri:level="1"><nlm:aff id="af4">Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì</wicri:regionArea>
<wicri:noRegion>Forlì</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Valeyre, Dominique" sort="Valeyre, Dominique" uniqKey="Valeyre D" first="Dominique" last="Valeyre">Dominique Valeyre</name>
<affiliation wicri:level="3"><nlm:aff id="af30">Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris 13 University, Sorbonne Paris Cité, Service de Pneumologie, Hopital Avicenne, Bobigny</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Bobigny</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wijsenbeek, Marlies" sort="Wijsenbeek, Marlies" uniqKey="Wijsenbeek M" first="Marlies" last="Wijsenbeek">Marlies Wijsenbeek</name>
<affiliation wicri:level="3"><nlm:aff id="af35">Dept of Pulmonary Diseases, Erasmus MC, University Hospital Rotterdam, Rotterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Dept of Pulmonary Diseases, Erasmus MC, University Hospital Rotterdam, Rotterdam</wicri:regionArea>
<placeName><settlement type="city">Rotterdam</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wuyts, Wim" sort="Wuyts, Wim" uniqKey="Wuyts W" first="Wim" last="Wuyts">Wim Wuyts</name>
<affiliation wicri:level="1"><nlm:aff id="af36">Respiratory Medicine, University Hospitals Leuven, Leuven, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Respiratory Medicine, University Hospitals Leuven, Leuven</wicri:regionArea>
<wicri:noRegion>Leuven</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hansell, David" sort="Hansell, David" uniqKey="Hansell D" first="David" last="Hansell">David Hansell</name>
<affiliation wicri:level="3"><nlm:aff id="af37">Dept of Thoracic Imaging, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Dept of Thoracic Imaging, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wells, Athol" sort="Wells, Athol" uniqKey="Wells A" first="Athol" last="Wells">Athol Wells</name>
<affiliation wicri:level="3"><nlm:aff id="af38">Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Interstitial Lung Disease Unit, Royal Brompton Hospital, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">The European Respiratory Journal</title>
<idno type="ISSN">0903-1936</idno>
<idno type="eISSN">1399-3003</idno>
<imprint><date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>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.</p>
<p>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 (κ<sub>w</sub>
). 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.</p>
<p>A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (κ<sub>w</sub>
=0.65, IQR 0.53–0.72, p<0.0001) than academic physicians (κ<sub>w</sub>
=0.56, IQR 0.45–0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (κ<sub>w</sub>
=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).</p>
<p>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.</p>
</div>
</front>
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</listBibl>
</div1>
</back>
</TEI>
</record>
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