The Diagnostic Yield of the Multidisciplinary Discussion in Patients With COVID-19 Pneumonia

oleh: Fiorella Calabrese, Federica Pezzuto, Chiara Giraudo, Luca Vedovelli, Francesco Fortarezza, Claudia Del Vecchio, Francesca Lunardi, Anna Sara Fraia, Elisabetta Cocconcelli, Stefania Edith Vuljan, Dario Gregori, Andrea Crisanti, Elisabetta Balestro, Paolo Spagnolo

Format: Article
Diterbitkan: Frontiers Media S.A. 2021-04-01

Deskripsi

Purpose: The hypothesis of the study was that a multidisciplinary approach involving experienced specialists in diffuse parenchymal lung disease might improve the diagnosis of patients with COVID-19 pneumonia.Methods: Two pulmonologists, two radiologists, and two pathologists reviewed 27 patients affected by severe COVID-19 pneumonia as the main diagnosis made by non-pulmonologists. To evaluate whether the contribution of specialists, individually and/or in combination, might modify the original diagnosis, a three-step virtual process was planned. The whole lung examination was considered the gold standard for the final diagnosis. The probability of a correct diagnosis was calculated using a model based on generalized estimating equations. The effectiveness of a multidisciplinary diagnosis was obtained by comparing diagnoses made by experienced pulmonologists with those made by non-pulmonologists.Results: In 19% of cases, the diagnosis of COVID-19-related death was mainly incorrect. The probability of a correct diagnosis increased strikingly from an undedicated clinician to an expert specialist. Every single specialist made significantly more correct diagnoses than any non-pulmonologist. The highest level of accuracy was achieved by the combination of 3 expert specialists (p = 0.0003).Conclusion: The dynamic interaction between expert specialists may significantly improve the diagnostic confidence and management of patients with COVID-19 pneumonia.