Implications of the diagnostic criteria of idiopathic pulmonary fibrosis in clinical practice: Analysis from the Australian Idiopathic Pulmonary Fibrosis Registry

Helen E. Jo, Ian Glaspole, Nicole Goh, Peter M.A. Hopkins, Yuben Moodley, Paul N. Reynolds, Sally Chapman, Eugene Haydn Walters, Christopher Zappala, Heather Allan, Sacha Macansh, Christopher Grainge, Gregory J. Keir, Andrew Hayen, Douglas Henderson, Sonja Klebe, Stefan B. Heinze, Anne Miller, Hannah C. Rouse, Edwina DuhigWendy A. Cooper, Annabelle M. Mahar, Samantha Ellis, Samuel R. McCormack, Bernard Ng, David B. Godbolt, Tamera J. Corte

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and objective: Current guidelines for the diagnosis of idiopathic pulmonary fibrosis (IPF) provide specific criteria for diagnosis in the setting of multidisciplinary discussion (MDD). We evaluate the utility and reproducibility of these diagnostic guidelines, using clinical data from the Australian IPF Registry. Methods: All patients enrolled in the registry undergo a diagnostic review whereby international IPF guidelines are applied via a registry MDD. We investigated the clinical applicability of these guidelines with regard to: (i) adherence to guidelines, (ii) Natural history of IPF diagnostic categories and (iii) Concordance for diagnostic features. Results: A total of 417 participants (69% male, 70.6 ± 8.0 years) with a clinical diagnosis of IPF underwent MDD. The 23% of participants who did not meet IPF diagnostic criteria displayed identical disease behaviour to those with confirmed IPF. Honeycombing on radiology was associated with a worse prognosis and this translated into poorer prognosis in the ‘definite’ IPF group. While there was moderate agreement for IPF diagnostic categories, agreement for specific radiological features, other than honeycombing, was poor. Conclusion: In clinical practice, physicians do not always follow IPF diagnostic guidelines. We demonstrate a cohort of IPF patients who do not meet IPF diagnostic guideline criteria, based largely on their radiology and lack of lung biopsy, but who have outcomes identical to those with IPF.

Original languageEnglish
Pages (from-to)361-368
Number of pages8
JournalRespirology
Volume24
Issue number4
DOIs
Publication statusPublished - 17 Oct 2019
Externally publishedYes

Keywords

  • honeycombing
  • idiopathic pulmonary fibrosis
  • multidisciplinary
  • registry

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    Jo, H. E., Glaspole, I., Goh, N., Hopkins, P. M. A., Moodley, Y., Reynolds, P. N., Chapman, S., Walters, E. H., Zappala, C., Allan, H., Macansh, S., Grainge, C., Keir, G. J., Hayen, A., Henderson, D., Klebe, S., Heinze, S. B., Miller, A., Rouse, H. C., ... Corte, T. J. (2019). Implications of the diagnostic criteria of idiopathic pulmonary fibrosis in clinical practice: Analysis from the Australian Idiopathic Pulmonary Fibrosis Registry. Respirology, 24(4), 361-368. https://doi.org/10.1111/resp.13427