Management of interstitial lung diseases: A consensus statement of the Indian Chest Society (ICS) and National College of Chest Physicians (NCCP)
Virendra Singh, Sheetu Singh, BharatBhushan Sharma, Mohan Bairwa, Dipti Gothi, Unnati Desai, JyotsnaM Joshi, Deepak Talwar, Abhijeet Singh, Raja Dhar, Ambika Sharma, Bineet Ahluwalia, DayaK Mangal, NirmalK Jain, Khushboo Pilania, Vijay Hadda, ParvaizA Koul, ShantiKumar Luhadia, Rajesh Swarnkar, ShailenderNath Gaur, AlokeG Ghoshal, Amita Nene, Arpita Jindal, Bhavin Jankharia, Ravindran Chetambath, Dhruv Choudhary, Digambar Behera, DJ Christopher, GopiC Khilnani, JaiKumar Samaria, Harpreet Singh, KrishnaBihari Gupta, Manju Pilania, ManoharL Gupta, Narayan Misra, Nishtha Singh, PrahladR Gupta, PrashantN Chhajed, Raj Kumar, Rajesh Chawla, RajendraK Jenaw, Rakesh K. Chawla, Randeep Guleria, Ritesh Agarwal, R Narsimhan, Sandeep Katiyar, Sanjeev Mehta, Sahajal Dhooria, SushmitaR Chowdhury, SurinderK Jindal, SubodhK Katiyar, Sudhir Chaudhri, Neeraj Gupta, Sunita Singh, Surya Kant, Zarir Udwadia, Ganesh Raghu
Abstract
BACKGROUND: Interstitial lung disease (ILD) is a complex and heterogeneous group of acute and chronic lung diseases of several known and unknown causes. While clinical practice guidelines (CPG) for idiopathic pulmonary fibrosis (IPF) have been recently updated, CPG for ILD other than IPF are needed. METHODS: A working group of multidisciplinary clinicians familiar with clinical management of ILD (pulmonologists, radiologist, pathologist, and rheumatologist) and three epidemiologists selected by the leaderships of Indian Chest Society and National College of Chest Physicians, India, posed questions to address the clinically relevant situation. A systematic search was performed on PubMed, Embase, and Cochrane databases. A modified GRADE approach was used to grade the evidence. The working group discussed the evidence and reached a consensus of opinions for each question following face-to-face discussions. RESULTS: Statements have been made for each specific question and the grade of evidence has been provided after performing a systematic review of literature. For most of the questions addressed, the available evidence was insufficient and of low to very low quality. The consensus of the opinions of the working group has been presented as statements for the questions and not as an evidence-based CPG for the management of ILD. CONCLUSION: This document provides the guidelines made by consensus of opinions among experts following discussion of systematic review of evidence pertaining to the specific questions for management of ILD other than IPF. It is hoped that this document will help the clinician understand the accumulated evidence and help better management of idiopathic and nonidiopathic interstitial pneumonias.