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The Diagnostic Yield of the Multidisciplinary Discussion in Patients With COVID-19 Pneumonia.
Calabrese, Fiorella; Pezzuto, Federica; Giraudo, Chiara; Vedovelli, Luca; Fortarezza, Francesco; Del Vecchio, Claudia; Lunardi, Francesca; Fraia, Anna Sara; Cocconcelli, Elisabetta; Vuljan, Stefania Edith; Gregori, Dario; Crisanti, Andrea; Balestro, Elisabetta; Spagnolo, Paolo.
  • Calabrese F; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Pezzuto F; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Giraudo C; Department of Medicine, University of Padova, Medical School, Padova, Italy.
  • Vedovelli L; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Fortarezza F; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Del Vecchio C; Department of Molecular Medicine, University of Padova, Medical School, Padova, Italy.
  • Lunardi F; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Fraia AS; Department of Medicine, University of Padova, Medical School, Padova, Italy.
  • Cocconcelli E; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Vuljan SE; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Gregori D; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Crisanti A; Department of Molecular Medicine, University of Padova, Medical School, Padova, Italy.
  • Balestro E; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
  • Spagnolo P; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Medical School, Padova, Italy.
Front Med (Lausanne) ; 8: 637872, 2021.
Article in English | MEDLINE | ID: covidwho-1191689
ABSTRACT

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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.637872

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.637872