@article {WalshPA3556, author = {Simon Walsh and Athol Wells and David Hansell}, title = {A multicentre evaluation of inter-multidisciplinary team agreement for diagnosis in diffuse lung disease}, volume = {48}, number = {suppl 60}, elocation-id = {PA3556}, year = {2016}, doi = {10.1183/13993003.congress-2016.PA3556}, publisher = {European Respiratory Society}, abstract = {Objectives: To evaluate the inter-multidisciplinary team (inter-MDT) agreement for diagnosis in the setting of diffuse lung disease (DLD).Methods: 7 MDTs from 7 different countries evaluated 70 cases of diffuse lung disease in a 2-step process. First, the clinician, radiologist and pathologist evaluated each case without consultation. This step was then repeated as an MDT following review of all clinical, radiologic and pathologic data. Interobserver agreement was calculated for each component of the MDT and for the final MDT diagnosis.Results: Overall inter-MDT agreement for diagnosis was 0.50. Overall interobserver agreement for diagnosis among clinicians, radiologists and pathologists was 0.44, 0.32 and 0.31 respectively. Idiopathic pulmonary fibrosis (IPF), idiopathic non-specific interstitial pneumonia (NSIP), connective tissue related interstitial lung disease (CTD-ILD) or hypersensitivity pneumonitis (HP) made up 67\% of the total number of first choice diagnoses. Inter-MDT agreement on diagnostic likelihoods was good for IPF (0.71) and CTD-ILD (0.73), moderate for NSIP (0.42) and poor for HP (0.29). Inter-MDT agreement for probability of idiopathic pulmonary fibrosis in patients without lung biopsy was 0.78 (IQR 0.74-0.83). Inter-MDT agreement was superior for each of these 4 diagnoses to interobserver agreement between clinicians or radiologists or pathologists.Conclusions: Agreement for diagnosis between MDTs in the setting of DLD is modest but superior to overall agreement between individual clinicians, radiologists or pathologists. The greatest inter-MDT disagreement occurs when diagnosing HP and, to a lesser extent, NSIP.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/48/suppl_60/PA3556}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }