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A. Unclassifiable and B. Nsip,

S. Figure, Concordance between center A and B for MDA2 diagnosis of: A: unclassifiable ILD, B: NSIP, C: UIP

, Interstitial Lung Disease, MDA: MultiDisciplinary Approach

. Récemment, CBTB) et biopsie pulmonaire chirurgicale (BPC), actuel gold standard, a été rapportée dans la démarche diagnostique des Pneumopathies Interstitielles Diffuses (PID). Cependant, ces résultats étaient issus d'une analyse anatomopathologique aveugle du contexte clinique et morphologique

, L'objectif de cette étude était d'évaluer la concordance diagnostique et de la décision thérapeutique entre CBTB et BPC, en réintégrant leurs résultats au sein d'une Discussion MultiDisciplinaire (DMD)

, Une des deux histologies (CBTB ou BPC), attribuée de manière randomisée, était présentée à l'une des DMD, l'autre DMD bénéficiant de l'histologie obtenue par l'autre méthode. Un diagnostic unique devait être émis (MDA2 Diagnostic) avec une décision thérapeutique (MDA2 traitement). Le coefficient de concordance Kappa a été évalué entre les MDA2 diagnostic et traitement des deux centres, PID ont été présentés en DMD dans deux centres de compétence

, Les Kappas pour les MDA2 diagnostic et traitement étaient bons, p.49

, 92), selon que l'histologie ait été obtenue par CBTC ou BPC. Entre le diagnostic à un an et le MDA2 diagnostic, le Kappa était excellent, pp.36-36

, La réintégration des données histologiques en DMD permet d'obtenir une meilleure concordance entre CBTB et BPC

, the current gold standard, has been reported in the diagnostic approach of diffuse Interstitial Lung Disease (ILD). However, in this study, pathological reports were analyzed by a pathologist blind from clinical and morphological data. The objective of this study was to evaluate the diagnostic and therapeutic decision concordances between TBLC and SLB, poor concordance between transbronchial cryobiopsy (TBLC) and surgical lung biopsy (SLB)

, One of the two pathological reports (TBLC or SLB), assigned randomly, was presented to one of the MDD, the other MDD benefiting from the histology obtained by the other method. A single diagnosis was proposed by each MDD (MDA2 Diagnosis) with a therapeutic decision (MDA2 treatment). Cohen Kappa concordance coefficient was evaluated between MDA2 diagnosis and treatment between TBLC and SLB

, Kappa coefficients for MDA2 diagnosis and treatment were good, respectively 0.74 (0.49-1), and 0.64 (0.36-0.92), depending on whether the histology was obtained by TBLC or SLB. When one year of follow-up was the gold standard, Kappa for SLB tended to be higher than Kappa for TBLC

, The reintegration of pathological results in MDD lead to a better concordance between TBLC and SLB. Mots clés : Pneumopathies interstitielles diffuses ; Cryobiopsie ; Biopsie pulmonaire chirurgicale

, Pneumopathie Interstitielle Commune

, Pneumopathie Insterstitielle Non Spécifique ; Endoscopie bronchique ; Tomographie à haute résolution Interstitial Lung Diseases; Cryobiopsy ; Surgical lung biopsy; Multidisciplinary discussion; Usual Insterstitial Pneumonia; Non Specific Interstitial Pneumonia, Bronchial endoscopy