Chest
Clinical InvestigationsDIFFUSE LUNG DISEASEThe Accuracy of the Clinical Diagnosis of New-Onset Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Disease: A Prospective Study
Section snippets
Subjects
The study population was composed of all symptomatic, adult, untreated patients with ILD consecutively referred to a senior ILD specialist (GR) for diagnostic evaluation of new-onset ILD without a specific diagnosis at the University of Washington Medical Center in Seattle, WA.
Definitions
- I.
ILD: Chest radiograph evidence of bilateral, diffuse parenchymal opacities (reticular, interstitial ± subsegmental opacities) in an apparently normal host.
- II.
New-onset ILD: Chest radiographic and/or HRCT evidence of ILD plus
Results
A total of 59 patients met criteria for the study from 1992 to 1997 (Table 1). Eighty-five percent of subjects had undergone nondiagnostic TBBX before undergoing SLB. Based on the patient's clinical status (eg, patients ability to tolerate TBBX, high suspicion for malignancy, etc) and/or preference, 9 of 59 patients (15%) were directly referred for SLB.
Patients’ ages ranged from 24 to 78 years (median, 53 years); and there were 24 women and 35 men. The median duration of symptoms was 14 months
Discussion
Over the last few years, the abnormal patterns of ILD and IPF on HRCT scans have been refined and are being increasingly recognized as diagnostic patterns. This has led to the increasing use of HRCT scans in conjunction with a thorough clinical assessment; it has been suggested that an accurate diagnosis of ILD can be made without SLB.3, 13 An accurate diagnosis of IPF and ILD is vital not only to direct appropriate therapy and determine prognosis, but also to design studies and clinical trials
References (16)
- et al.
The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy
Chest
(1995) Idiopathic pulmonary fibrosis: a rational, clinical approach
Chest
(1987)Open and closed lung biopsy
Interstitial lung disease: a diagnostic approach—are CT scan and lung biopsy indicated in every patient?
Am J Respir Crit Care Med
(1995)- et al.
Importance of ground glass attenuation in chronic diffuse infiltrative lung disease: pathologic CT correlation
Radiology
(1993) - et al.
Pulmonary sarcoidosis: correlation of CT and histopathologic findings
Radiology
(1993) - et al.
Chronic diffuse infiltrative lung disease: a comparison of diagnostic accuracy of CT and chest radiography
Radiology
(1989) - et al.
Designing a new study: III. Diagnostic tests
Cited by (377)
Interstitial lung disease in systemic lupus erythematosus: state of the art search
2024, Revista Colombiana de ReumatologiaIdiopathic pulmonary fibrosis: Diagnosis, biomarkers and newer treatment protocols
2023, Disease-a-MonthFrench practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis – 2021 update. Full-length version
2023, Respiratory Medicine and ResearchFrench practical guidelines for the diagnosis and management of IPF – 2021 update, full version
2022, Revue des Maladies Respiratoires