Manuela Funke-Chambour, Sabina A. Guler, Thomas Geiser, Andreas Christe, Johannes Heverhagen, Alexander Pöllinger, Adrian Huber, Lukas Ebner
European Respiratory Journal 2019; DOI: 10.1183/13993003.00905-2019
The ATS/ERS/JRS/ALAT recently released a new clinical practice guideline (ATS/ERS/JRS/ALAT2018) for idiopathic pulmonary fibrosis (IPF) with simultaneously proposed diagnostic criteria by the Fleischner Society. [1, 2] Both diagnostic algorithms agree on most diagnostic steps, with divergent recommendations on the position of surgical lung biopsy (SLB): ATS/ERS/JRS/ALAT2018 recommends SLB in most patients with probable usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) (conditional recommendation), whereas the Fleischner society proposes to forgo SLB in patients with definite or probable UIP HRCT pattern, presenting in the right clinical context. [3, 4] We aimed to quantify the impact of the previous (ATS/ERS/JRS/ALAT2011)  and the two new diagnostic approaches [1, 2] on real-life clinical practice, with assessment of radiological inter-rater agreement, diagnostic test characteristics, and prognostic validity of the diverging radiological diagnoses for a multidisciplinary IPF diagnosis in our cohort.
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Conflict of interest: Dr. Funke-Chambour reports grants from Roche, grants from Boehringer Ingelheim, grants from Intermune, during the conduct of the study.
Conflict of interest: Dr. Guler has nothing to disclose.
Conflict of interest: Dr. Geiser has nothing to disclose.
Conflict of interest: Dr. Christe has nothing to disclose.
Conflict of interest: Dr. Heverhagen has nothing to disclose.
Conflict of interest: Alexander Pollinger
Conflict of interest: Dr. Huber has nothing to disclose.
Conflict of interest: Dr. Ebner has nothing to disclose.
Conflict of interest: Dr. Poellinger has nothing to disclose.