{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:23:09Z","timestamp":1790713389861,"version":"4.1.0"},"reference-count":19,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T00:00:00Z","timestamp":1599004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Multidisciplinary team (MDT) discussion is the gold standard in the management of interstitial lung disease (ILD). The rheumatologist is not routinely involved in MDT, even if up to 20% of ILD are related to systemic autoimmune rheumatic diseases (SARD). The study aims to assess the agreement and its variation over time between rheumatologists and pulmonologists in the screening of SARD and between rheumatologists and an MDT extended to rheumatologists (eMDT) in evaluating the progression of SARD. We computed the agreement between the pulmonologist and rheumatologist in the identification of red flags for SARDs of 81 ILD cases and between the rheumatologist alone and eMDT in the confirmation of 70 suspected SARD-ILD progressions. The agreement between rheumatologists and pulmonologists was moderate for the detection of autoimmunity test positivity (\u03ba = 0.475, p &lt; 0.001) and family history of SARD (\u03ba = 0.491, p &lt; 0.001) and fair for the identification of extrapulmonary symptoms (\u03ba = 0.225, p = 0.064) or routine laboratory abnormalities consistent with SARD. The average agreement between the rheumatologist and eMDT in the identification of ILD progression was moderate (\u03ba = 0.436, p &lt; 0.001). The class of agreement improved from the first to the third semester. The average agreement with the rheumatologist ranged from fair to moderate, suggesting that a shared evaluation of SARD-ILD in eMDT could improve the diagnostic work-up and the evaluation of ILD progression.<\/jats:p>","DOI":"10.3390\/diagnostics10090664","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T09:29:28Z","timestamp":1599038968000},"page":"664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Multidisciplinary Evaluation of Interstitial Lung Diseases: New Opportunities Linked to Rheumatologist Involvement"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9819-105X","authenticated-orcid":false,"given":"Enrico","family":"De Lorenzis","sequence":"first","affiliation":[{"name":"Institute of Rheumatology, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Ph.D. program in Biomolecular Medicine-Cycle XXXV, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Laura","family":"Bosello","sequence":"additional","affiliation":[{"name":"Divisione di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Varone","sequence":"additional","affiliation":[{"name":"UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Sgalla","sequence":"additional","affiliation":[{"name":"UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucio","family":"Calandriello","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerlando","family":"Natalello","sequence":"additional","affiliation":[{"name":"Institute of Rheumatology, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Iovene","sequence":"additional","affiliation":[{"name":"UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8714-3124","authenticated-orcid":false,"given":"Giuseppe","family":"Cicchetti","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5953-3440","authenticated-orcid":false,"given":"Laura","family":"Gigante","sequence":"additional","affiliation":[{"name":"Institute of Rheumatology, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1658-6694","authenticated-orcid":false,"given":"Lucrezia","family":"Verardi","sequence":"additional","affiliation":[{"name":"Institute of Rheumatology, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gremese","sequence":"additional","affiliation":[{"name":"Institute of Rheumatology, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Divisione di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Richeldi","sequence":"additional","affiliation":[{"name":"UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rita","family":"Larici","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Radiological and Hematological Sciences, Section of Radiology, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1164\/rccm.2009-040GL","article-title":"An official ATS\/ERS\/JRS\/ALAT statement: Idiopathic pulmonary fibrosis: Evidence-based guidelines for diagnosis and management","volume":"183","author":"Raghu","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S0140-6736(12)61079-4","article-title":"Interstitial lung disease in connective tissue disorders [published correction appears in Lancet. 2012 Sep 29;380(9848):1148]","volume":"380","author":"Fischer","year":"2012","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.chest.2017.05.015","article-title":"Lung Manifestations in the Rheumatic Diseases","volume":"152","author":"Doyle","year":"2017","journal-title":"Chest"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1164\/rccm.201807-1255ST","article-title":"American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline","volume":"198","author":"Raghu","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1183\/23120541.00209-2018","article-title":"The characterisation of interstitial lung disease multidisciplinary team meetings: A global study","volume":"5","author":"Richeldi","year":"2019","journal-title":"ERJ Open Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.3899\/jrheum.171314","article-title":"Rheumatological Assessment Is Important for Interstitial Lung Disease Diagnosis","volume":"45","author":"Levi","year":"2018","journal-title":"J. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2448","DOI":"10.21037\/jtd.2019.05.46","article-title":"Clinical significance of Charlson comorbidity index as a prognostic parameter for patients with acute or subacute idiopathic interstitial pneumonias and acute exacerbation of collagen vascular diseases-related interstitial pneumonia","volume":"11","author":"Murohashi","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1183\/13993003.00150-2015","article-title":"\u201cERS\/ATS Task Force on Undifferentiated Forms of CTD-ILD\u201d. 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Open."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"129","DOI":"10.4103\/0256-4947.60518","article-title":"Inter- and intraobserver variation between radiologists in the detection of abnormal parenchymal lung changes on high-resolution computed tomography","volume":"30","author":"Athyal","year":"2010","journal-title":"Ann. Saudi Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1590\/S1806-37132010000100007","article-title":"Observer agreement in the diagnosis of interstitial lung diseases based on HRCT scans","volume":"36","author":"Antunes","year":"2010","journal-title":"J. Bras. Pneumol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1136\/thoraxjnl-2015-207252","article-title":"Interobserver agreement for the ATS\/ERS\/JRS\/ALAT criteria for a UIP pattern on CT","volume":"71","author":"Walsh","year":"2016","journal-title":"Thorax"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6452","DOI":"10.1038\/s41598-019-42813-7","article-title":"The Role of Follow-up Evaluation in the Diagnostic Algorithm of Idiopathic Interstitial Pneumonia: A Retrospective Study","volume":"9","author":"Han","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"c5064","DOI":"10.1136\/bmj.c5064","article-title":"Impact of workplace based assessment on doctors\u2019 education and performance: A systematic review","volume":"341","author":"Miller","year":"2010","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/RCT.0b013e3182277d05","article-title":"Method for minimizing observer variation for the quantitation of high-resolution computed tomographic signs of lung disease","volume":"35","author":"Sverzellati","year":"2011","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1800692","DOI":"10.1183\/13993003.00692-2018","article-title":"What\u2019s in a name? That which we call IPF, by any other name would act the same","volume":"51","author":"Wells","year":"2018","journal-title":"Eur. Respir. 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