TY - JOUR
T1 - Nationwide cloud-based integrated database of idiopathic interstitial pneumonias for multidisciplinary discussion
AU - Fujisawa, Tomoyuki
AU - Mori, Kazutaka
AU - Mikamo, Masashi
AU - Ohno, Takashi
AU - Kataoka, Kensuke
AU - Sugimoto, Chikatoshi
AU - Kitamura, Hideya
AU - Enomoto, Noriyuki
AU - Egashira, Ryoko
AU - Sumikawa, Hiromitsu
AU - Iwasawa, Tae
AU - Matsushita, Shoichiro
AU - Sugiura, Hiroaki
AU - Hashisako, Mikiko
AU - Tanaka, Tomonori
AU - Terasaki, Yasuhiro
AU - Kunugi, Shinobu
AU - Kitani, Masashi
AU - Okuda, Ryo
AU - Horiike, Yasuoki
AU - Enomoto, Yasunori
AU - Yasui, Hideki
AU - Hozumi, Hironao
AU - Suzuki, Yuzo
AU - Nakamura, Yutaro
AU - Fukuoka, Junya
AU - Johkoh, Takeshi
AU - Kondoh, Yasuhiro
AU - Ogura, Takashi
AU - Inoue, Yoshikazu
AU - Hasegawa, Yoshinori
AU - Inase, Naohiko
AU - Homma, Sakae
AU - Suda, Takafumi
N1 - Funding Information:
Our cohort did not reflect true populations of patients with IIPs in the real world, because all patients included underwent SLB. Accordingly, the observations of the present study, such as the proportion of each category of IIP diagnosis, may not be applicable to general populations with IIPs. It is of course very important in the clinical setting to differentiate IIPs from ILDs with a known cause, such as CHP or CTD-ILD. Therefore, it will be important to evaluate the performance of MDD diagnosis for a wider range of ILDs. However, the present study, which was funded by the Japanese Ministry of Health, formed a part of the Practical Research Project for Rare Intractable Diseases from the Japan Agency for Medical Research and Development. The definition of rare diseases included IIPs, but excluded other entities such as CHP or CTD-ILD. Our nationwide database for this study was therefore designed to include only patients with IIPs. In this context, the present study clearly indicates that our MDD system performed well in our cohort with good feasibility. The web-based MDD system can easily be applicable to other ILDs. Thus, this system we built could be a promising platform to enable MDD for a variety of ILDs other than IIPs. In the clinical setting, MDD is also performed in cases of ILD without SLB. To further explore this concept, we are currently planning a prospective cohort study including ILDs other than biopsy-proven IIPs. In addition, the digitised clinical, radiological and pathological data of patients with IIPs diagnosed by MDD in our database may be a valuable resource for developing an artificial intelligence-based multimodal diagnostic system for ILD.
Funding Information:
Support statement: This research is supported by the Practical Research Project for Rare Intractable Diseases from the Japan Agency for Medical Research and Development, and Grant-in-Aid for Diffuse Lung Diseases Research Group from the Japanese Ministry of Health, Labour and Welfare. Funding information for this article has been deposited with the Crossref Funder Registry.
Publisher Copyright:
Copyright © ERS 2019. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Multidisciplinary discussion (MDD) requiring close communication between specialists (clinicians, radiologists and pathologists) is the gold standard for the diagnosis of idiopathic interstitial pneumonias (IIPs). However, MDD by specialists is not always feasible because they are often separated by time and location. An online database would facilitate data sharing and MDD. Our aims were to develop a nationwide cloud-based integrated database containing clinical, radiological and pathological data of patients with IIPs along with a web-based MDD system, and to validate the diagnostic utility of web-based MDD in IIPs. Clinical data, high-resolution computed tomography images and lung biopsy slides from patients with IIPs were digitised and uploaded to separate servers to develop a cloud-based integrated database. Web-based MDD was performed using the database and video-conferencing to reach a diagnosis. Clinical, radiological and pathological data of 524 patients in 39 institutions were collected, uploaded and incorporated into the cloud-based integrated database. Subsequently, web-based MDDs with a pulmonologist, radiologist and pathologist using the database and video-conferencing were successfully performed for the 465 cases with adequate data. Overall, the web-based MDD changed the institutional diagnosis in 219 cases (47%). Notably, the MDD diagnosis yielded better prognostic separation among the IIPs than did the institutional diagnosis. This is the first study of developing a nationwide cloud-based integrated database containing clinical, radiological and pathological data for web-based MDD in patients with IIPs. The database and the web-based MDD system that we built made MDD more feasible in practice, potentially increasing accurate diagnosis of IIPs.
AB - Multidisciplinary discussion (MDD) requiring close communication between specialists (clinicians, radiologists and pathologists) is the gold standard for the diagnosis of idiopathic interstitial pneumonias (IIPs). However, MDD by specialists is not always feasible because they are often separated by time and location. An online database would facilitate data sharing and MDD. Our aims were to develop a nationwide cloud-based integrated database containing clinical, radiological and pathological data of patients with IIPs along with a web-based MDD system, and to validate the diagnostic utility of web-based MDD in IIPs. Clinical data, high-resolution computed tomography images and lung biopsy slides from patients with IIPs were digitised and uploaded to separate servers to develop a cloud-based integrated database. Web-based MDD was performed using the database and video-conferencing to reach a diagnosis. Clinical, radiological and pathological data of 524 patients in 39 institutions were collected, uploaded and incorporated into the cloud-based integrated database. Subsequently, web-based MDDs with a pulmonologist, radiologist and pathologist using the database and video-conferencing were successfully performed for the 465 cases with adequate data. Overall, the web-based MDD changed the institutional diagnosis in 219 cases (47%). Notably, the MDD diagnosis yielded better prognostic separation among the IIPs than did the institutional diagnosis. This is the first study of developing a nationwide cloud-based integrated database containing clinical, radiological and pathological data for web-based MDD in patients with IIPs. The database and the web-based MDD system that we built made MDD more feasible in practice, potentially increasing accurate diagnosis of IIPs.
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U2 - 10.1183/13993003.02243-2018
DO - 10.1183/13993003.02243-2018
M3 - Article
C2 - 30880283
AN - SCOPUS:85066420862
SN - 0903-1936
VL - 53
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 5
M1 - 1802243
ER -