SCREENING AT-RISK PATIENTS

ILD should be considered in all patients with chronic cough and exertional dyspnea1

50 percent of patients with IPF are initially misdiagnosed with other common respiratory diseases

of patients with IPF are initially misdiagnosed with other common respiratory diseases.2

Does patient have chronic cough and exertional dyspnea?
 

Yes, with productive cough
Yes, with nonproductive cough
No, patient does not have chronic cough and exertional dyspnea

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354.



Patient is suspected of having ILD/IPF.

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354.

Typical of COPD and CHF3,4

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354. 3. American Thoracic Society. Am J Respir Crit Care Med. 1995;152(5 Pt 2):S77-S121. 4. Mayo Clinic. Heart failure symptoms. http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/symptoms/con-20029801. Accessed December 2, 2021.

Typical of ILDs, including IPF, and asthma; uncommon in COPD3-6

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354. 3. American Thoracic Society. Am J Respir Crit Care Med. 1995;152(5 Pt 2):S77-S121. 4. Mayo Clinic. Heart failure symptoms. http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/symptoms/con-20029801. Accessed December 2, 2021. 5. Ryu JH et al. Mayo Clin Proc. 2007;82(8):976-986. 6. Kaufman J. Nurse management. http://booksite.elsevier.com/samplechapters/9780323065801/9780323065801.pdf. Accessed December 2, 2021.

No, patient does not have chronic cough and exertional dyspnea

Restart
Full algorithm

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354.

Perform PFT and evaluate results as

Obstructive
Restrictive
Full algorithm

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354.

Typical of asthma and COPD3

Restart
Full algorithm

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354. 3. Johnson JD et al. Am Fam Physician. 2014;89(5):359-366.

Results typical of ILDs, including IPF, or in CHF3,4

Continue to evaluate for ILD/IPF diagnosis
Suspect ILD/IPF?
Full algorithm

References:
1. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2011;183(6):788-824. 2. Collard HR et al. Respir Med. 2007;101:1350-1354. 3. Johnson JD et al. Am Fam Physician. 2014;89(5):359-366. 4. von Cleemput J et al. Adv Ther. 2019;36(2):298-317. doi:10.1007/s12325-018-0857-z.