TY - JOUR
T1 - Integration and Application of Clinical Practice Guidelines for the Diagnosis of Idiopathic Pulmonary Fibrosis and Fibrotic Hypersensitivity Pneumonitis
AU - Marinescu, Daniel Costin
AU - Raghu, Ganesh
AU - Remy-Jardin, Martine
AU - Travis, William D.
AU - Adegunsoye, Ayodeji
AU - Beasley, Mary Beth
AU - Chung, Jonathan H.
AU - Churg, Andrew
AU - Cottin, Vincent
AU - Egashira, Ryoko
AU - Fernández Pérez, Evans R.
AU - Inoue, Yoshikazu
AU - Johannson, Kerri A.
AU - Kazerooni, Ella A.
AU - Khor, Yet H.
AU - Lynch, David A.
AU - Müller, Nestor L.
AU - Myers, Jeffrey L.
AU - Nicholson, Andrew G.
AU - Rajan, Sujeet
AU - Saito-Koyama, Ryoko
AU - Troy, Lauren
AU - Walsh, Simon L.F.
AU - Wells, Athol U.
AU - Wijsenbeek, Marlies S.
AU - Wright, Joanne L.
AU - Ryerson, Christopher J.
N1 - Funding Information:
Funding/support: The authors have reported to CHEST that no funding was received for this study. Financial/nonfinancial disclosures: None declared.
Publisher Copyright:
© 2022 American College of Chest Physicians
PY - 2022/9
Y1 - 2022/9
N2 - Recent clinical practice guidelines have addressed the diagnosis of idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (fHP). These disease-specific guidelines were developed independently, without clear direction on how to apply their respective recommendations concurrently within a single patient, where discrimination between these two fibrotic interstitial lung diseases represents a frequent diagnostic challenge. The objective of this review, created by an international group of experts, was to suggest a pragmatic approach on how to apply existing guidelines to distinguish IPF and fHP. Key clinical, radiologic, and pathologic features described in previous guidelines are integrated in a set of diagnostic algorithms, which then are placed in the broader context of multidisciplinary discussion to guide the generation of a consensus diagnosis. Although these algorithms necessarily reflect some uncertainty wherever strong evidence is lacking, they provide insight into the current approach favored by experts in the field based on currently available knowledge. The authors further identify priorities for future research to clarify ongoing uncertainties in the diagnosis of fibrotic interstitial lung diseases.
AB - Recent clinical practice guidelines have addressed the diagnosis of idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (fHP). These disease-specific guidelines were developed independently, without clear direction on how to apply their respective recommendations concurrently within a single patient, where discrimination between these two fibrotic interstitial lung diseases represents a frequent diagnostic challenge. The objective of this review, created by an international group of experts, was to suggest a pragmatic approach on how to apply existing guidelines to distinguish IPF and fHP. Key clinical, radiologic, and pathologic features described in previous guidelines are integrated in a set of diagnostic algorithms, which then are placed in the broader context of multidisciplinary discussion to guide the generation of a consensus diagnosis. Although these algorithms necessarily reflect some uncertainty wherever strong evidence is lacking, they provide insight into the current approach favored by experts in the field based on currently available knowledge. The authors further identify priorities for future research to clarify ongoing uncertainties in the diagnosis of fibrotic interstitial lung diseases.
KW - clinical practice guidelines
KW - hypersensitivity pneumonitis
KW - idiopathic pulmonary fibrosis
KW - multidisciplinary discussion
KW - usual interstitial pneumonia
UR - http://www.scopus.com/inward/record.url?scp=85136485276&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2022.06.013
DO - 10.1016/j.chest.2022.06.013
M3 - Review article
C2 - 35738345
AN - SCOPUS:85136485276
VL - 162
SP - 614
EP - 629
JO - Chest
JF - Chest
SN - 0012-3692
IS - 3
ER -