[Evaluation of the reliability of the diagnostic methods in farmer's lung]

Following a study of the diagnosis of farmer's lung (PDF) carried out in 1763 active farm workers in Doubs, 294 (16.7%) were suspected of PDF and they were invited to a secondary consultation in hospital for a further work up which consisted of a clinical examination for crepitations (RC) on pulmonary auscultation (AP) and for evidence of an interstitial lung disorder (SI) on pulmonary radiograph (RP) and for evidence of a restrictive syndrome (SR) on pulmonary function tests (EFR). 238 patients (80%) accepted the additional assessment and were divided into two groups on the basis of the history and serology (precipitin tests), group 1: probable PDF (n = 65): symptoms suggestive of PDF in the presence of serum precipitins; group 2: possible PDF (n = 173): non specific symptoms with or without serum precipitins. RC were present in 21.9% of patients in group 1 and 6.4% of patients in group 2 (p less than 0.001). There was an SI in 9.2% of patients in group 1 and 4% of patients in group 2 (non significant). For the elevated radiology scores for SI there was a significant difference: 7.7% for SI in group 1 and 1.73% in group 2 (p less than 0.05). There was 38.1% of abnormal EFR in group 1 and 14.7% in group 2 (p less than 0.001) but the difference of the frequency of SR in the 2 groups was not statistically significant (9.5% in group 1 and 4.7% in group 2). In this study, an additional assessment (AP, RP, EFR) carried out at a difficult moment during winter does not appear to confirm great benefit.(ABSTRACT TRUNCATED AT 250 WORDS)