Comparison of MDD across two different ILD referral centers using the same CRF

Current evidence shows that the diagnostic accuracy for interstitial lung diseases (ILD) increased through the multidisciplinary discussion (MDD). However, a significant heterogeneity among ILD centers exists in terms of MDD composition and few data on direct comparison of MDD have been published so far. To address this clinical challenge, data from MDDs of two ILD referral centers have been compared. Patients discussed during MDD were prospectively recruited in two referral ILD centers (San Antonio, TX, USA, and Rozzano, Milan, Italy). The same case report form (CRF) was used in both centers. Pre-MDD and post-MDD diagnosis were assessed for all the patients. Pre-MDD diagnoses were categorized into three groups, idiopathic pulmonary fibrosis (IPF), not-IPF, and unspecified ILD, while post-MDD diagnoses were IPF, not-IPF, and unclassifiable ILD. The primary objective of the study was the absolute change in diagnostic trajectories post-MDD across the two centers. 242 patients (median age: 69 years; 56% males) were included. 62% of diagnoses (n=124) were changed following MDD in San Antonio versus 17% (n=7) in Rozzano (p<0.001). Treatment was changed post-MDD in 53% (n=106) of ILD patients in San Antonio and 34% (n=14) in Rozzano (p=0.039). Additional tests and/or specialistic referral were required in 63% (n=127) of ILD patients post-MDD in San Antonio versus 78% (n=32) in Rozzano (p=0.073). Our study strengthens the knowledge that MDD has an impact on diagnostic trajectories and management of ILD patients.