Building Effective Interstitial Lung Disease Multidisciplinary Meetings: An Operational Guide for Virtual and In-person Models in India

ARTICLEon any single diagnostic modality risks misclassification and inappropriate therapy.With the expansion of antifibrotic therapies and evolving concepts such as progressive fibrosing ILD, diagnostic precision has become increasingly important.To address this complexity, international consensus statements recommend multidisciplinary discussion (MDD) as the reference standard for ILD diagnosis. [6][7]7][8] In a structured MDD, pulmonologists, thoracic radiologists, pulmonary pathologists, and rheumatologists integrate clinical, radiologic, serologic, and histopathologic data to reach a unified working diagnosis with an assigned level of confidence.Studies have demonstrate that MDD changes the initial IntroductIonInterstitial lung diseases (ILDs) represent a heterogeneous group of more than 200 diffuse parenchymal lung disorders characterized by varying degrees of inflammation and fibrosis involving the lung interstitium.Although individually uncommon, ILDs collectively contribute significantly to respiratory morbidity and mortality.Accurate classification is critical, as prognosis, therapeutic responsiveness, antifibrotic eligibility, and timing of transplantation referral differ substantially across subtypes. 1,2 The diagnostic evaluation of ILD is inherently complex.Patients typically present with nonspecific symptoms such as exertional dyspnea and chronic cough, while pulmonary function tests demonstrate restriction and impaired diffusing capacity.Highresolution computed tomography (HRCT) has transformed ILD assessment by enabling pattern-based classification and distribution analysis.However, radiologic patterns frequently overlap, particularly between idiopathic pulmonary fibrosis (IPF), fibrotic hypersensitivity pneumonitis (HP), and connective tissue disease-associated ILD (CTD-ILD). [3][4]4][5] Distinguishing a usual interstitial pneumonia (UIP) pattern from chronic HP or autoimmune-related fibrosis has direct therapeutic implications and is not always straightforward.Similarly, isolated serologic positivity may not confirm systemic autoimmune disease, and histopathologic patterns require careful clinicoradiologic correlation.Biopsy findings may overlap across entities, and invasive sampling carries procedural risks.Reliance