Multidisciplinary approach in the diagnosis and treatment of interstitial lung diseases

2025

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DOI 10.17116/respmed2025104119
Data confidence 70 medium
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Abstract

The diagnosis of interstitial lung diseases (ILDs) remains a challenging clinical task, as neither clinical presentation nor radiological or morphological data alone are sufficient to establish an accurate diagnosis. Multidisciplinary discussion (MDD) is recognized as the «gold standard» for diagnosing ILD, integrating data from all specialists to determine the final diagnosis and treatment strategy. Objective. To summarize international experience in team-based diagnosis of ILD and to present the results of our own multidisciplinary expert group’s work based on the analysis of patient registry data. Material and methods. A retrospective descriptive analysis of data from an ILD registry (n=504) was conducted. The nosological structure of diseases in the registry was studied. Particular attention was paid to analyzing diagnosis changes following MDD within the activities of the expert commission from 2022 to 2025. The practical work of the commission in selecting patients for specific therapy was also characterized (186 cases analyzed to determine indications for antifibrotic therapy). Results. The nosological structure of ILD according to the registry data (based on 504 cases) is presented. The dynamics of changes in initial diagnoses after MDD were demonstrated, confirming its critical role in disease verification. Using the example of 186 cases, the key role of MDD in clinical decision-making, particularly in determining indications for prescribing antifibrotic therapy, was shown. Conclusions. Multidisciplinary discussion is an integral and the most effective tool in the modern diagnostic algorithm for ILD. The experience of the expert group based on the patient registry confirms that MDD not only increases diagnostic accuracy but also directly influences the choice of treatment tactics, aligning with international standards for managing patients with interstitial lung pathology. The implementation and development of this approach are essential for improving the quality of care for patients with ILD.