An Official American Thoracic Society/European Respiratory Society Statement: Update of the International Multidisciplinary Classification of the Idiopathic Interstitial Pneumonias

Abstract

This update is a supplement to the previous 2002 IIP classification document. It outlines advances in the past decade and potential areas for future investigation.

Evaluation of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society position statement

“…13 MDD was first recommended in the 2002 consensus statement describing the classification of the IIPs 3 and has since been considered the gold standard for ILD diagnosis. 3,4 MDD improves diagnostic accuracy (measured as interobserver agreement) in both community and academic settings compared to diagnoses made independently. 13 Inter-observer agreement is higher among academic compared to community physicians, with the latter group more likely to assign a diagnosis of IPF, 14 illustrating the importance of diagnosing ILD using a MDD among ILD experts.…”

“…2,4,13 The high inter-observer agreement among academic radiologists suggests the potential for greater diagnostic accuracy; however, the specific clinical implications of this finding are currently unknown. Academic radiologists have higher inter-observer agreement than community radiologists for the interpretation of HRCT for ILD, with the latter having a greater tendency to report a usual interstitial pneumonia (UIP) pattern.…”

“…Current diagnostic guidelines are based on limited evidence and focus on idiopathic pulmonary fibrosis (IPF) or other idiopathic interstitial pneumonias (IIPs); [2][3][4] however, a more general approach is needed at the time of initial assessment. A recent survey of Canadian respirologists revealed heterogeneous practice patterns and deviations from international consensus recommendations.…”

Die idiopathische Lungenfibrose

“…Daten aus Groß-britannien lassen eine Inzidenz von 8,6 Patienten/ 100 000 Einwohner in Deutschland vermuten [1]. Die IPF gehört damit noch zu den seltenen Lungenerkrankungen und Medikamente für die IPF tragen einen "orphan drug" Status [2].…”

“…Die idiopathische Lungenfibrose ist mit einem Anteil von 33 % die häufigste Form der Lungenfibrosen, die auch als interstitielle Pneumonien (IIP) klassifiziert werden. Aufgrund histologischer Merkmale erfolgt in der aktuellen Klassifikation eine Einteilung in 9 Subtypen [6]. Histologisch liegt der IPF die "Usual Interstitial Pneumonitis" (UIP) zugrunde.…”