PhD Scientific Days 2025

Poster Session II. - W: Conservative Medicine

Diagnostic confidence level of the interstitial lung disease multidisciplinary team: how certain is the diagnosis?

Name of the presenter

Fésü Dorottya

Institute/workplace of the presenter

Semmelweis University, Department of Pulmonology

Authors

Dorottya Fésü MD¹, Zsófia Király¹, Noémi Eszes MD¹, Krisztina Vincze MD¹, Anikó Bohács MD¹, Veronika Müller MD; DSc¹

1: Semmelweis University, Department of Pulmonology

Text of the abstract

Introduction: The diagnosis of interstitial lung disease (ILD) is a complex process that requires the expertise of a multidisciplinary ILD team (ILD-MDT). Fast and accurate diagnosis is crucial in determining the most appropriate treatment; therefore, the assessment of the confidence level of diagnoses is important and could be improved.
Aims: The present study aims to analyze the diagnoses made during ILD-MDT meetings between January and December 2024 at the Department of Pulmonology, Semmelweis University, with a particular focus on the level of diagnostic confidence and its therapeutic implications.
Methods: This study retrospectively analyzed 244 cases discussed in 2024 ILD multidisciplinary team meetings at Semmelweis University. Patients were divided as high-confidence diagnosis group (N=80, 32.8%) or non-high-confidence group (N=164, 67.2%).
Results: The mean age was 64.6±14.7 years, with 43.9% male patients. No sex-based differences were observed (p=0.89), but younger patients were more likely to receive a high-confidence diagnosis (60.9±16.8 vs. 66.4±13.2 years, OR=0.97, p=0.006). The most common diagnoses were idiopathic interstitial pneumonia (IIP, 34%), ILD of known etiology (32%), and granulomatous ILD (17%). Idiopathic pulmonary fibrosis accounted for 12.7%, while 17.2% had connective tissue disease-associated ILD (CTD-ILD). Granulomatous ILD and CTD-ILD diagnoses were linked to high confidence levels (OR=3.3, p=0.001; OR=3.5, p<0.001), mainly due to the availability of tissue samples or known CTD. IIP was associated with lower confidence (OR=0.4, p=0.004). The most common CT patterns were ground-glass opacity (50.8%) and usual interstitial pneumonia (22.5%). Emphysema correlated with lower confidence (9.5%, OR=0.17, p<0.001). Additional tests were recommended more often in low-confidence cases, while therapeutic recommendations were more frequent in high-confidence cases (43.8% vs. 23.2%, OR=2.6, p=0.001).
Conclusion: This is the first Hungarian study on ILD diagnostic confidence levels, highlighting associations with age and disease subtypes.
Funding: SE 250+ scholarship; Scientific Research Funding from the Hungarian Pulmonology Fundation
Contact: Dorottya Fésü; fesu.dorottya@semmelweis.hu