CHEST Guidelines-Hiding-in-Plain-Sight_2020

Hiding-in-Plain-Sight_2020_chest

Pdf Summary

The article by Daniel Dilling discusses the prevalence and challenges in the diagnosis of interstitial lung disease (ILD), a condition with nonspecific symptoms often mistaken for COPD. Epidemiological studies have reported variable prevalence rates, largely due to differences in data collection settings and definitions. Importantly, many studies underrepresent patients from primary care and non-pulmonologist settings, potentially underestimating true prevalence. A French study proposes a higher ILD prevalence rate of 100 per 100,000. <br /><br />Late diagnosis of ILD is a significant issue, leading to delayed treatment and potentially earlier mortality. The article emphasizes the need for greater clinical awareness and suggests that proper diagnostic tools like spirometry tests or complete pulmonary function testing should be employed before reaching a diagnosis of COPD.<br /><br />The potential of machine learning and artificial intelligence as diagnostic aids is explored, notably a new tool developed by Pugashetti et al., termed "ILD-Screen," which predicts ILD using data from pulmonary function tests (PFT). This model has a high negative predictive value and surpasses traditional clinical prediction methods, facilitating quicker and more accurate ILD detection. Use of the ILD-Screen resulted in increased and expedited chest CTs, leading to earlier diagnosis of ILD, even in patients from non-specialist settings.<br /><br />However, the implementation of this tool necessitates its integration into clinical practice, prompting actions like ordering CT scans from PFT results. The article concludes by asserting the continued need for vigilant clinicians who pay attention to indications like lung crackles, despite advances in diagnostic technology. The initiative ultimately aims to improve patient outcomes by ensuring earlier and more reliable ILD detection, leading to timely therapeutic interventions.

Keywords

interstitial lung disease

ILD diagnosis

COPD misdiagnosis

epidemiological studies

clinical awareness

machine learning

artificial intelligence

ILD-Screen tool

pulmonary function tests

early diagnosis