Can a virtual multi-centre multi-disciplinary discussion improve the diagnosis and management of interstitial lung disease? A retrospective cohort study across multiple institutions.

Abstract

Multi-disciplinary discussions (MDDs) improve diagnosis and management of interstitial lung disease (ILD). The value of a virtual multi-centre MDD (V-MCMDD) incorporating expertise from multiple institutions remains underexplored. This study aimed to evaluate the impact of a V-MCMDD on diagnosis and management in ILD. We conducted a retrospective multi-centre cohort study involving tertiary and secondary hospital clinics, private practices and community outpatient centres, all participating via a virtual platform. Between August 2020 and June 2023, patient cases were reviewed through V-MCMDDs, which included clinical, radiological, pathological and laboratory data. Each case was discussed to reach a consensus diagnosis and management plan. Following the V-MCMDD review, the diagnosis was revised in 51% of patients (p=0.031), and management plans were modified in 41% of cases. A significant shift in treatment was observed in patients with changed diagnoses vs unchanged diagnoses (p value=0.002). Our findings suggest that the implementation of V-MCMDDs can be valuable in the diagnostic and therapeutic process for ILD. Incorporating input from multiple centres via a virtual format can lead to significant changes in both diagnosis and management, potentially improving patient outcomes.