{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:45:31Z","timestamp":1791229531705,"version":"4.1.0"},"reference-count":17,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,15]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess diagnostic concordance and reclassification following an India-led, multinational virtual multidisciplinary discussion (V-MDD) platform for interstitial lung disease (ILD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, multicentre service-evaluation study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Twenty-four Indian referral centres connected through a secure virtual platform, with international faculty participation from the UK, Greece and Sri Lanka.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 127 anonymised ILD cases discussed across 29 V-MDD sessions (February 2024\u2013February 2025). Each panel included \u22654 pulmonologists, two pulmonary pathologists, one of three rotating thoracic radiologists and one of two rheumatologists, along with international experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort (mean age 52.6\u00b116.1 years; 53.5% female (68\/127)) most frequently presented with dyspnoea (82.6%) and cough (73.2%). Pre-V-MDD diagnoses included hypersensitivity pneumonitis (HP) and sarcoidosis as distinct disease entities, and usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP) as radiological patterns, along with connective tissue disease (CTD)-ILD and other ILDs. Concordance between pre- and post-V-MDD CT diagnoses was substantial (\u03ba=0.658; 95%\u2009CI 0.562 to 0.754; p &lt;0.001). Histopathology concordance was similarly high (\u03ba=0.861 for HP; \u03ba=0.650 for other ILDs). Overall, 23% of cases were reclassified following discussion. Diagnostic stability was greatest for organising pneumonia, CTD-ILD and UIP pattern, whereas HP and sarcoidosis showed the highest reclassification rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The India-led, multinational V-MDD model demonstrated substantial diagnostic concordance and refined nearly one-quarter of ILD diagnoses. This virtual, scalable framework expands access to subspecialty expertise and offers a practical blueprint for standardising ILD care in resource-limited and cross-border settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-110693","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T16:10:25Z","timestamp":1767111025000},"page":"e110693","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Virtual multidisciplinary discussion across borders for interstitial lung disease: a prospective, multicentre study from India, the UK, Greece and Sri Lanka"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2937-0454","authenticated-orcid":false,"given":"Asmita Anilkumar","family":"Mehta","sequence":"first","affiliation":[{"name":"RespiratoryMedicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, 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Sciences, Kochi, KL, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BVM","family":"Mohan","sequence":"additional","affiliation":[{"name":"Narayana Health, Bangalore, KA, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vimal","family":"Raj","sequence":"additional","affiliation":[{"name":"Narayana Health, Bengaluru, KA, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Kulshrestha","sequence":"additional","affiliation":[{"name":"Department of Pathology, Vallabhbhai Patel Chest Institute Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pralhad","family":"Prabhudesai","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Lilavati Hospital and Research Centre, Mumbai, MH, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Irodi","sequence":"additional","affiliation":[{"name":"CMC Vellore, Vellore, 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