Accuracy of diagnosis of idiopathic pulmonary fibrosis

¹ Universitaire Ziekenhuizen, Katholieke Universiteit Leuven, Belgium; and Ziekenhuis Oost Limburg, Genk, Belgium
² Universitaire Ziekenhuizen, Katholieke Universiteit Leuven, Belgium
³ Medizinische Klinik I, Klinikum Grosshadern der Ludwig-Maximilians-Universität, Munich, Germany
⁴ Medizinische Klinik III, Klinikum der Johannes-Gutenberg-Universität, Mainz, Germany
⁵ Abteilung Pneumologie/Allergologie, Ruhrlandklinik, Essen-Heidhausen, Germany
⁶ Evelyn Hospital, Cambridge, UK
⁷ Hôpital Cardiologique, CHU de Bordeaux, France
⁸ Royal Brompton Hospital, London, UK
⁹ Hôpital Antoine-Béclère, Clarmart, France
¹⁰ Zambon Group, Bresso, Milan, Italy

^* To whom correspondence should be addressed. E-mail: michiel.thomeer{at}scarlet.be.

	Abstract

The purpose of this study is to evaluate the accuracy of the diagnosis of idiopathic pulmonary fibrosis by respiratory physicians in 6 European countries and to calculate the inter-observer agreement between HRCT reviewers and histology reviewers in the diagnosis of IPF. After the diagnosis was assessed by the local investigator, following the ATS/ERS consensus statement, the diagnosis of usual interstitial pneumonia was confirmed when a minimum 2 of 3 expert reviewers of each expert panel agreed with the diagnosis. The level of agreement between the readers within each expert panel was calculated by weighted kappa. The diagnosis of UIP was confirmed in 87.2% of the cases by the expert panels. A total of 179 HRCT scans were independently reviewed and an inter-observer agreement of 0.40 was found. In 97 patients an open or thoracoscopic biopsy was performed, 82 of these could be reviewed by the expert committee. The weighted kappa between the histology readers was 0.30. We conclude that although the level of agreement between readers within each panel is only fair to moderate, the overall accuracy of a clinical diagnosis of IPF in expert centers is good (87,2%).

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