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Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis.
Hunninghake, G W; Zimmerman, M B; Schwartz, D A; King, T E; Lynch, J; Hegele, R; Waldron, J; Colby, T; Müller, N; Lynch, D; Galvin, J; Gross, B; Hogg, J; Toews, G; Helmers, R; Cooper, J A; Baughman, R; Strange, C; Millard, M.
Affiliation
  • Hunninghake GW; Department of Medicine, University of Iowa and Veterans Affairs Medical Center, Iowa City, IA 52242, USA. gary-hunninghake@uiowa.edu
Am J Respir Crit Care Med ; 164(2): 193-6, 2001 Jul 15.
Article in En | MEDLINE | ID: mdl-11463586
ABSTRACT
It is not known if a surgical lung biopsy is necessary in all patients for the diagnosis of idiopathic pulmonary fibrosis (IPF). We conducted a blinded, prospective study at eight referring centers. Initially, cases were evaluated by clinical history and examination, transbronchial biopsy, and high-resolution lung computed tomography scans. Pulmonologists at the referring centers then assessed their certainty of the diagnosis of IPF and provided an overall diagnosis, before surgical lung biopsy. The lung biopsies were reviewed by a pathology core and 54 of 91 patients received a pathologic diagnosis of IPF. The positive predictive value of a confident (certain) clinical diagnosis of IPF by the referring centers was 80%. The positive predictive value of a confident clinical diagnosis was higher, when the cases were reviewed by a core of pulmonologists (87%) or radiologists (96%). Lung biopsy was most important for diagnosis in those patients with an uncertain diagnosis and those thought unlikely to have IPF. These studies suggest that clinical and radiologic data that result in a confident diagnosis of IPF by an experienced pulmonologist or radiologist are sufficient to obviate the need for a lung biopsy. Lung biopsy is most helpful when clinical and radiologic data result in an uncertain diagnosis or when patients are thought not to have IPF.
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Collection: 01-internacional Database: MEDLINE Main subject: Pulmonary Fibrosis Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Respir Crit Care Med Journal subject: TERAPIA INTENSIVA Year: 2001 Document type: Article Affiliation country: Estados Unidos
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Collection: 01-internacional Database: MEDLINE Main subject: Pulmonary Fibrosis Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Respir Crit Care Med Journal subject: TERAPIA INTENSIVA Year: 2001 Document type: Article Affiliation country: Estados Unidos