Diagnosis of Idiopathic Pulmonary Fibrosis: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline
AI-Generated Summary
Educational summary — always verify with primary sourceIPF diagnosis requires integration of clinical, radiological (HRCT), and pathological data. The 2022 guideline updated the 2018 guideline with new evidence on HRCT patterns and BAL.
ATS/ERS/JRS/ALAT evidence-based guideline using GRADE methodology.
Key updates: (1) Four HRCT UIP patterns: typical, probable, indeterminate, alternative diagnosis; (2) Typical UIP on HRCT in appropriate clinical context = IPF diagnosis without biopsy; (3) BAL lymphocytosis >40% suggests alternative diagnosis; (4) Genomic classifier (Envisia) conditionally recommended.
Know the four HRCT UIP patterns and when biopsy is needed. Typical UIP (bilateral basal honeycombing ± traction bronchiectasis) in the right clinical context = IPF without biopsy. Probable UIP may require biopsy. Alternative diagnosis pattern = look for other ILD.
Guideline — some recommendations are conditional with low-quality evidence. Genomic classifier not universally available.
Access the complete publication on PubMed