Diagnosis of idiopathic pulmonary fibrosis by virtual means using "IPFdatabase"- a new software.


Journal

Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438

Informations de publication

Date de publication:
02 2019
Historique:
received: 16 08 2018
revised: 24 12 2018
accepted: 26 12 2018
entrez: 2 2 2019
pubmed: 2 2 2019
medline: 24 3 2020
Statut: ppublish

Résumé

The diagnostic algorithm for idiopathic pulmonary fibrosis (IPF) guidelines has some shortcomings. The aim of the present study was to develop a novel software, "IPFdatabase", that could readily apply the diagnostic criteria per IPF guidelines and make a 'virtual' diagnosis of IPF. Software was developed as a step-by-step compilation of necessary information according to guidelines to enable a diagnosis of IPF. Software accuracy was validated primarily by comparing software diagnoses to those previously made at a Center for Interstitial Lung Diseases. Clinical validation on 98 patients (68 male, age 61.0 ± 8.5 years), revealed high software accuracy for IPF diagnosis when compared to historical diagnoses (sensitivity 95.5%, specificity 96.2%; positive predictive value 95.5%, negative predictive value 96.2%). A general radiologist and a general pathologist reviewed relevant data with and without the new software: interobserver agreement increased when they used the IPFdatabase (kappa 0.18 to 0.64 for radiology, 0.13 to 0.59 for pathology). IPFdatabase is a useful diagnostic tool for typical cases of IPF, and potentially restricts the need for MDDs to atypical and complex cases. We propose this web-designed software for instant accurate diagnosis of IPF by virtual means and for educational purposes; the software is readily accessed with mobile apps, allows incorporation of updated version of guidelines, can be utilized for gathering data useful for future studies and give physicians rapid feedback in daily practice.

Sections du résumé

BACKGROUND
The diagnostic algorithm for idiopathic pulmonary fibrosis (IPF) guidelines has some shortcomings. The aim of the present study was to develop a novel software, "IPFdatabase", that could readily apply the diagnostic criteria per IPF guidelines and make a 'virtual' diagnosis of IPF.
METHODS
Software was developed as a step-by-step compilation of necessary information according to guidelines to enable a diagnosis of IPF. Software accuracy was validated primarily by comparing software diagnoses to those previously made at a Center for Interstitial Lung Diseases.
RESULTS
Clinical validation on 98 patients (68 male, age 61.0 ± 8.5 years), revealed high software accuracy for IPF diagnosis when compared to historical diagnoses (sensitivity 95.5%, specificity 96.2%; positive predictive value 95.5%, negative predictive value 96.2%). A general radiologist and a general pathologist reviewed relevant data with and without the new software: interobserver agreement increased when they used the IPFdatabase (kappa 0.18 to 0.64 for radiology, 0.13 to 0.59 for pathology).
CONCLUSION
IPFdatabase is a useful diagnostic tool for typical cases of IPF, and potentially restricts the need for MDDs to atypical and complex cases. We propose this web-designed software for instant accurate diagnosis of IPF by virtual means and for educational purposes; the software is readily accessed with mobile apps, allows incorporation of updated version of guidelines, can be utilized for gathering data useful for future studies and give physicians rapid feedback in daily practice.

Identifiants

pubmed: 30704696
pii: S0954-6111(18)30400-1
doi: 10.1016/j.rmed.2018.12.011
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

31-36

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

David Bennett (D)

Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Maria Antonietta Mazzei (MA)

Diagnostic Imaging Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Bridget Collins (B)

Center for Interstitial Lung Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington (UW), Seattle, USA.

Elena Bargagli (E)

Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Sudhakar Pipavath (S)

Center for Interstitial Lung Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington (UW), Seattle, USA; Department of Radiology, University of Washington (UW), Seattle, USA.

Donatella Spina (D)

Pathology Unit, Azienda Ospedaliera Universitaria Senese (AOUS), Siena, Italy.

Maria Lucia Valentini (ML)

Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Cesare Rinaldi (C)

Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Gloria Bettini (G)

Radiology Unit, Emergency Department, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy.

Alessandro Ginori (A)

Pathology Unit, Apuane Hospital, Azienda USL Toscana Nord Ovest, Carrara, Italy.

Rosa Metella Refini (RM)

Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Paola Rottoli (P)

Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) and Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.

Ganesh Raghu (G)

Center for Interstitial Lung Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington (UW), Seattle, USA. Electronic address: graghu@uw.edu.

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Classifications MeSH