Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline

作者：Ganesh Raghu, Martine Rémy‐Jardin, Jeffrey L. Myers, Luca Richeldi, Christopher J. Ryerson, David J. Lederer, Jürgen Behr, Vincent Cottin, Sonye K. Danoff, Ferrán Morell, Kevin Flaherty, Athol U. Wells, Fernando J. Martínez, Arata Azuma, Thomas Bice, Demosthenes Bouros, Kevin M. Brown, Harold R. Collard, Abhijit Duggal, Liam Galvin, Yoshikazu Inoue, Gísli Jenkins, Takeshi Johkoh, Ella A. Kazerooni, Masanori Kitaichi, Shandra L. Knight, George Mansour, Andrew G. Nicholson, Sudhakar Pipavath, Ivette Buendía-Roldán, Moisés Selman, William D. Travis, Simon Walsh, Kevin C. Wilson · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2018 · DOI：10.1164/rccm.201807-1255st · 被引用次数：4212 · 研究领域：Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis、Chronic Obstructive Pulmonary Disease (COPD) Research、Systemic Sclerosis and Related Diseases

BACKGROUND: This document provides clinical recommendations for the diagnosis of idiopathic pulmonary fibrosis (IPF). It represents a collaborative effort between the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. METHODS: The evidence syntheses were discussed and recommendations formulated by a multidisciplinary committee of IPF experts. The evidence was appraised and recommendations were formulated, written, and graded using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: The guideline panel updated the diagnostic criteria for IPF. Previously defined patterns of usual interstitial pneumonia (UIP) were refined to patterns of UIP, probable UIP, indeterminate, and alternate diagnosis. For patients with newly detected interstitial lung disease (ILD) who have a high-resolution computed tomography scan pattern of probable UIP, indeterminate, or an alternative diagnosis, conditional recommendations were made for performing BAL and surgical lung biopsy; because of lack of evidence, no recommendation was made for or against performing transbronchial lung biopsy or lung cryobiopsy. In contrast, for patients with newly detected ILD who have a high-resolution computed tomography scan pattern of UIP, strong recommendations were made against performing surgical lung biopsy, transbronchial lung biopsy, and lung cryobiopsy, and a conditional recommendation was made agains...