Essential Features of an Interstitial Lung Disease Multidisciplinary Meeting: An International Delphi Survey.

Abstract

RATIONALE\nThe interstitial lung disease (ILD) multidisciplinary meetings (MDM) composing of pulmonologists, radiologists and pathologists, is integral to the rendering of an accurate ILD diagnosis. However, there is significant heterogeneity in the conduct of ILD MDMs and questions regarding its best practice remain unanswered.\n\n\nOBJECTIVE\nTo achieve consensus among ILD experts on essential components of an ILD MDM.\n\n\nMETHODS\nUsing a Delphi methodology, semi structured interviews with ILD experts were used to identify key themes and features of ILD MDMs. These items informed two subsequent rounds of online questionnaires that were used to achieve consensus among a broader, international panel of ILD experts. Experts were asked to rate their level of agreement on a five-point Likert scale. An a priori threshold for consensus was set at a median score 4 or 5 with an interquartile range of 0.\n\n\nRESULTS\nWe interviewed 15 ILD experts and 102 ILD experts participated in the online questionnaires. Five items and two exploratory statements achieved consensus on being essential for an ILD MDM following two questionnaire rounds. There was consensus that the presence of at least one radiologist, a quiet setting with a visual projection system, a high-quality chest high resolution computed tomography and a standardized template summarising collated patient data are essential components of an ILD MDM. Experts also agreed that it would be useful for ILD MDMs to undergo an annual benchmarking process and a validation process by fulfilling a minimum number of cases annually. Twenty-seven additional features were considered to be either highly desirable or desirable features based on the degree of consensus. Although our findings on desirable features are similar to the current literature, several of these remain controversial and warrant further research. The study also showed an agreement among participants on several future concepts to improve the ILD MDM such as performing regular self-assessments and conducting research into shared practices to develop an international expert guideline statement on ILD MDMs.\n\n\nCONCLUSION\nThis Delphi study showed consensus among international ILD experts on essential and desirable features of an ILD MDM. Our data represents a first step toward potential collaborative research into future standardisation of ILD MDMs.