Peer-to-Peer Dialogue

Peer-to-Peer Dialogue features insightful audio commentary from a multidisciplinary group of experts in interstitial lung disease. Listen in for state-of-the-art information as they address timely, clinically relevant topics identified by the PILOT™ Steering Committee.

  Diagnosis

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Questions Discussed:	Windows [WMA]:	Mac [MP3]:
Diagnosis: Full audio (includes all questions)	Listen: [21 minutes]	Listen: [21 minutes]
To biopsy or not to biopsy: When are you confident enough to not proceed with a SLB?	Listen: [8 minutes]	Listen: [8 minutes]
Do you have any difficulty distinguishing IPF from NSIP and other IIPs? How do you go about ruling out other similar disease states?	Listen: [8 minutes]	Listen: [8 minutes]
Are there any clinical or radiographic findings that allow the clinician to identify which patients might be at risk for acute exacerbations? Are there any diagnostic criteria for acute exacerbations?	Listen: [6 minutes]	Listen: [6 minutes]

  Prognosis

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Questions Discussed:	Windows [WMA]:	Mac [MP3]:
What are the most common predictors you use to determine the prognosis of patients with IPF? How useful is the 6MWT as a prognostic tool? Which is more relevant, O2 saturation or distance? Are there any baseline indicators that clearly portend a poor prognosis?	Listen: [8 minutes]	Listen: [8 minutes]

  Disease Management

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Questions Discussed:	Windows [WMA]:	Mac [MP3]:
What are your greatest challenges in getting patients to enroll in clinical trials, and how do you overcome those challenges? What is your experience with the ATS/ERS-recommended therapies? How do you manage a patient who presents with an acute exacerbation?	Listen: [8 minutes]	Listen: [8 minutes]

  The Patient Perspective

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Questions Discussed:	Windows [WMA]:	Mac [MP3]:
What questions do you hear most frequently from your patients and how do you answer? What are the major topics that need to be discussed with patients recently diagnosed with IPF? (Intubation, DNRs, etc) How do you go about locating support groups and education for IPF patients and their families? What are your thoughts regarding the utility of pulmonary rehab for patients with IPF?	Listen: [8 minutes]	Listen: [8 minutes]

  Comorbidities

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Questions Discussed:	Windows [WMA]:	Mac [MP3]:
How frequently do you see GERD in your IPF patients? Is there any evidence or causality? What is the prevalence of pulmonary arterial hypertension in advanced IPF patients? What is its impact on your management of those patients? Are you managing IPF patients with comorbid depression or referring them to psychiatrists? What about counseling?	Listen: [13 minutes]	Listen: [13 minutes]

  Lung Transplant Guidelines

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Questions Discussed:	Windows [WMA]:	Mac [MP3]:
Explain the new lung allocation system. How have the guidelines affected your management approach? Is there any difference between a single and a double lung transplant in terms of outcomes? Early referral for a transplant evaluation seems prudent; however, current clinical trials generally exclude patients on a transplant list. How do you approach this dilemma?	Listen: [14 minutes]	Listen: [14 minutes]

  Examining the Concept of Stable Disease in IPF

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Topics Discussed:	Windows [WMA]:	Mac [MP3]:
In light of the evolving understanding of disease progression, how is “stable” disease in patients with IPF defined? Discussion of the reference time frame for assessing stability and the measures they are using. A 10% decline in FVC is widely regarded as a threshold for defining clinical progression in patients with IPF - discussion of whether there is any clinical relevance to changes of less than 10%. Discussion of how the concept of acute exacerbations affects their overall patient management.	Listen: [31 minutes]	Listen: [31 minutes]

  Redefining the Concept of Disease Severity in IPF

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Topics Discussed:	Windows [WMA]:	Mac [MP3]:
Review of the most common chief complaints of patients at their initial evaluation, and the challenges of separating the IPF symptoms from those that might be attributed to a comorbidity. Discussion of how clinical, radiographic, and pathologic evaluations pertain to burden of disease, as well as how recent evidence and diagnostic criteria are used to evaluate periods of accelerated decline in patients with IPF. Discussion of how quality of life in IPF patients impacts the strategies used to manage patients.	Listen: [32 minutes]	Listen: [32 minutes]