American Journal of Respiratory and Critical Care Medicine· 2018Q1· Clinical trial
Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline
- 4,135citations
- Q1SCImago
- 2018year
Short summary
New clinical practice guidelines refine diagnostic criteria for idiopathic pulmonary fibrosis (IPF), updating imaging patterns and specifying when lung biopsies and bronchoalveolar lavage (BAL) are conditionally recommended or strongly advised against.
AI-generated from the title and abstract; the full text is not read.
Key points
- IPF diagnostic criteria updated with refined high-resolution CT scan patterns.
- Strong recommendations against surgical lung biopsy, transbronchial biopsy, and lung cryobiopsy for patients with a UIP CT pattern.
- Conditional recommendations for BAL in specific indeterminate or alternate diagnosis CT patterns.
- Conditional recommendation for multidisciplinary discussion in IPF diagnosis.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND: This document provides clinical recommendations for the diagnosis of idiopathic pulmonary fibrosis (IPF). It represents a collaborative effort between the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. METHODS: The evidence syntheses were discussed and recommendations formulated by a multidisciplinary committee of IPF experts. The evidence was appraised and recommendations were formulated, written, and graded using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: The guideline panel updated the diagnostic criteria for IPF. Previously defined patterns of usual interstitial pneumonia (UIP) were refined to patterns of UIP, probable UIP, indeterminate, and alternate diagnosis. For patients with newly detected interstitial lung disease (ILD) who have a high-resolution computed tomography scan pattern of probable UIP, indeterminate, or an alternative diagnosis, conditional recommendations were made for performing BAL and surgical lung biopsy; because of lack of evidence, no recommendation was made for or against performing transbronchial lung biopsy or lung cryobiopsy. In contrast, for patients with newly detected ILD who have a high-resolution computed tomography scan pattern of UIP, strong recommendations were made against performing surgical lung biopsy, transbronchial lung biopsy, and lung cryobiopsy, and a conditional recommendation was made against performing BAL. Additional recommendations included a conditional recommendation for multidisciplinary discussion and a strong recommendation against measurement of serum biomarkers for the sole purpose of distinguishing IPF from other ILDs. CONCLUSIONS: The guideline panel provided recommendations related to the diagnosis of IPF.
The authors' abstract, as published at the source. American Journal of Respiratory and Critical Care Medicine, 2018 · DOI ↗
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Field: Pulmonary and Respiratory Medicine
Pulmonary and Respiratory MedicineMedicine