{
  "abstract": "Objectives To assess diagnostic concordance and reclassification following an India-led, multinational virtual multidisciplinary discussion (V-MDD) platform for interstitial lung disease (ILD).Design Prospective, multicentre service-evaluation study.Setting Twenty-four Indian referral centres connected through a secure virtual platform, with international faculty participation from the UK, Greece and Sri Lanka.Participants A total of 127 anonymised ILD cases discussed across 29 V-MDD sessions (February 2024–February 2025). Each panel included ≥4 pulmonologists, two pulmonary pathologists, one of three rotating thoracic radiologists and one of two rheumatologists, along with international experts.Results The cohort (mean age 52.6±16.1 years; 53.5% female (68/127)) most frequently presented with dyspnoea (82.6%) and cough (73.2%). Pre-V-MDD diagnoses included hypersensitivity pneumonitis (HP) and sarcoidosis as distinct disease entities, and usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP) as radiological patterns, along with connective tissue disease (CTD)-ILD and other ILDs. Concordance between pre- and post-V-MDD CT diagnoses was substantial (κ=0.658; 95% CI 0.562 to 0.754; p <0.001). Histopathology concordance was similarly high (κ=0.861 for HP; κ=0.650 for other ILDs). Overall, 23% of cases were reclassified following discussion. Diagnostic stability was greatest for organising pneumonia, CTD-ILD and UIP pattern, whereas HP and sarcoidosis showed the highest reclassification rates.Conclusions The India-led, multinational V-MDD model demonstrated substantial diagnostic concordance and refined nearly one-quarter of ILD diagnoses. This virtual, scalable framework expands access to subspecialty expertise and offers a practical blueprint for standardising ILD care in resource-limited and cross-border settings.",
  "authors": [
    {
      "affiliations": [
        "RespiratoryMedicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India"
      ],
      "name": "Asmita Anilkumar Mehta"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Bombay Hospital Institute of Medical Sciences, Mumbai, India"
      ],
      "name": "Sujeet Rajan"
    },
    {
      "affiliations": [
        "Department of Pulmonology, Apex Institute, Kochi, KL, India"
      ],
      "name": "Subin Ahmed"
    },
    {
      "affiliations": [
        "Consultant Radiologist, Picture This, Mumbai, India"
      ],
      "name": "Bhavin Jankharia"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "Athol U Wells"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology, Amrita Institute of Medical Sciences, Kochi, KL, India"
      ],
      "name": "Mithun CB"
    },
    {
      "affiliations": [
        "Narayana Health, Bangalore, KA, India"
      ],
      "name": "BVM Mohan"
    },
    {
      "affiliations": [
        "Narayana Health, Bengaluru, KA, India"
      ],
      "name": "Vimal Raj"
    },
    {
      "affiliations": [
        "Department of Pathology, Vallabhbhai Patel Chest Institute Delhi, Delhi, India"
      ],
      "name": "Ritu Kulshrestha"
    },
    {
      "affiliations": [
        "Department of Pulmonary Medicine, Lilavati Hospital and Research Centre, Mumbai, MH, India"
      ],
      "name": "Pralhad Prabhudesai"
    },
    {
      "affiliations": [
        "CMC Vellore, Vellore, India"
      ],
      "name": "Aparna Irodi"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, KL, India"
      ],
      "name": "Lakshmi Priya Valathara Pradeep"
    },
    {
      "affiliations": [
        "Respiratory Medicine, National Hospital, Galle, Sri Lanka"
      ],
      "name": "Amila Rathnapala"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Laboratory of Molecular and Cellular Pneumonology, School of Medicine, University of Crete, Heraklion, Greece"
      ],
      "name": "KM Antoniou"
    },
    {
      "affiliations": [
        "Cpath Referral Labs, Mumbai, Maharashtra, India"
      ],
      "name": "Sharada Nagoti"
    }
  ],
  "title": "Virtual multidisciplinary discussion across borders for interstitial lung disease: a prospective, multicentre study from India, the UK, Greece and Sri Lanka",
  "uid": "eab5108c-af38-57af-a7cc-323b207f200a"
}