DOI: 10.30565/medalanya.1977534 ISSN: 2587-0319

Evaluation of Diagnostic Concordance Between Multidisciplinary Thoracic Board Decisions and Final Diagnoses: A Single-Center Retrospective Study

Aliye Gamze Çalış, Fatih Üzer, Ruşen Uzun, İdris Demir, Hakan Keskin, Ömer Özbudak, Aykut Çilli, Mustafa Karaca
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Aim: Multidisciplinary thoracic boards (MTB) improve diagnostic accuracy for complex lung diseases, yet robust data on real-world performance particularly concordance between preliminary and final diagnoses remain limited. This study quantitatively evaluated diagnostic performance, described patient and clinical characteristics, and identified factors associated with discordance. Methods: We retrospectively analyzed 157 patients discussed in MTBs between January 2022 and December 2024. Excluding 24 patients lacking follow-up, the final cohort comprised 133 patients. Data included demographics, smoking history, comorbidities, imaging, board decisions, and final diagnoses. Diagnostic performance was evaluated using a 2×2 contingency table, ROC analysis, sensitivity, specificity, and McNemar's test. Results: The cohort (mean age 62.4±11.6 years; 40.1% female) included never-smokers (30.6%). Comorbidities were present in 88.5%. Referrals originated mainly from pulmonology (77.7%). Preliminary board malignancy diagnosis was 71.4%. Common CT findings were solid nodules (42.7%) and ground-glass opacities (21.7%). Recommendations favored wedge biopsy (33.8%) and CT follow-up (33.1%). Final diagnoses included adenocarcinoma (12.8%), squamous cell carcinoma (9.0%), metastasis (10.5%), infection (15.8%), sarcoidosis (4.5%), and others (45.1%). Non-attenders (n=24) mostly received tissue sampling recommendations (75.0%). At the natural clinical threshold, preliminary assessment showed 93.1% sensitivity, 34.6% specificity, 28.4% PPV, and 94.7% NPV; ROC-optimal cutoff yielded 62% sensitivity and 62% specificity. McNemar's test showed a significant difference between paired preliminary and final malignancy classifications(p

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