Abstract
Abstract Rationale: Guidelines for screening for interstitial lung disease (ILD) in patients with systemic autoimmune rheumatic diseases (SARDs) have recently been published by the American College of Rheumatology and American College of Chest Physicians. We assessed practices for screening for SARD-ILD among physicians in central and Eastern Europe. Methods: Pulmonologists and rheumatologists from central and Eastern Europe who were treating patients with lung fibrosis were surveyed using Survey Monkey between February and April 2024. Physicians were asked whether they proactively screen patients with SARDs at risk for ILD and if so, which tools they usually use. Responses were analyzed according to specialty (pulmonologist or rheumatologist) and level of healthcare (secondary care [private practice, private hospital, community hospital] or tertiary care [tertiary hospital, university clinic]). The average use of screening tools per specialty and per level of healthcare was calculated across countries with ≥9 respondents. Results: A total of 1160 physicians (654 pulmonologists, 506 rheumatologists) from 13 countries (Austria, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Israel, Kazakhstan, Latvia, Poland, Romania, Serbia, Slovakia) provided responses to at least one question about screening tools. Use of all screening tools was higher among physicians working in tertiary care than secondary care (Figure). In secondary care, among pulmonologists and rheumatologists, respectively, 46% and 52% screened for SARD-ILD using chest auscultation, 45% and 48% using forced vital capacity (FVC), and 43% and 47% using HRCT. In tertiary care, among pulmonologists and rheumatologists, respectively, 65% and 73% screened for SARD-ILD using chest auscultation, 67% and 72% using FVC, and 64% and 71% using HRCT. Lung ultrasound was the least frequently used screening tool, used by fewer than 30% of physicians in both secondary and tertiary care. Conclusions: A survey of pulmonologists and rheumatologists from central and Eastern Europe suggested that guideline-recommended screening tools for SARD-ILDs, such as lung function tests and HRCT, are underused, especially in secondary care. Lung auscultation was only used for screening for SARD-ILDs by about half of the respondents working in secondary care.