Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice

Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice

Abstract The purpose of this study was to evaluate the implications of the 2018 updated guideline for the diagnosis of idiopathic pulmonary fibrosis (IPF) in clinical practice compared to 2011 guideline. This study involved 535 patients including 339 IPF and 196 non-IPF, and we retrospectively evalu...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Jooae Choe, Byoung Soo Kwon, Kyung-Hyun Do, Hee Sang Hwang, Jin Woo Song, Eun Jin Chae
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
Materias:
Medicine
R
Science
Q
Acceso en línea:https://doaj.org/article/28c281b769bd4a858e9a094e9c9e4700
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:28c281b769bd4a858e9a094e9c9e4700
record_format dspace
spelling oai:doaj.org-article:28c281b769bd4a858e9a094e9c9e47002021-12-02T16:27:54ZDiagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice10.1038/s41598-021-95728-72045-2322https://doaj.org/article/28c281b769bd4a858e9a094e9c9e47002021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95728-7https://doaj.org/toc/2045-2322Abstract The purpose of this study was to evaluate the implications of the 2018 updated guideline for the diagnosis of idiopathic pulmonary fibrosis (IPF) in clinical practice compared to 2011 guideline. This study involved 535 patients including 339 IPF and 196 non-IPF, and we retrospectively evaluated CT classifications of usual interstitial pneumonia (UIP) by two guidelines. Interobserver agreement of 2018 criteria showed moderate reliability (κ = 0.53) comparable to 2011 (κ = 0.56) but interobserver agreement for probable UIP was fair (κ = 0.40). CT pattern of indeterminate for UIP was associated with better prognosis compared with the other groups (adjusted hazard ratio [HR] = 0.36, p < 0.001). Compared to possible UIP, probable UIP demonstrated a lower positive predictive value (PPV, 62.9% vs 65.8%). In analysis of patients with CT patterns of non-definite UIP, diagnosing IPF when CT pattern showed probable UIP with lymphocyte count ≤ 15% in BAL fluid, and either male sex or age ≥ 60 years showed a high specificity of 90.6% and a PPV of 80.8% in the validation cohort. The 2018 criteria provide better prognostic stratification than the 2011 in patients with possible UIP. BAL fluid analysis can improve the diagnostic certainty for IPF diagnosis in patients with probable UIP CT pattern.Jooae ChoeByoung Soo KwonKyung-Hyun DoHee Sang HwangJin Woo SongEun Jin ChaeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Jooae Choe
Byoung Soo Kwon
Kyung-Hyun Do
Hee Sang Hwang
Jin Woo Song
Eun Jin Chae
Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
description Abstract The purpose of this study was to evaluate the implications of the 2018 updated guideline for the diagnosis of idiopathic pulmonary fibrosis (IPF) in clinical practice compared to 2011 guideline. This study involved 535 patients including 339 IPF and 196 non-IPF, and we retrospectively evaluated CT classifications of usual interstitial pneumonia (UIP) by two guidelines. Interobserver agreement of 2018 criteria showed moderate reliability (κ = 0.53) comparable to 2011 (κ = 0.56) but interobserver agreement for probable UIP was fair (κ = 0.40). CT pattern of indeterminate for UIP was associated with better prognosis compared with the other groups (adjusted hazard ratio [HR] = 0.36, p < 0.001). Compared to possible UIP, probable UIP demonstrated a lower positive predictive value (PPV, 62.9% vs 65.8%). In analysis of patients with CT patterns of non-definite UIP, diagnosing IPF when CT pattern showed probable UIP with lymphocyte count ≤ 15% in BAL fluid, and either male sex or age ≥ 60 years showed a high specificity of 90.6% and a PPV of 80.8% in the validation cohort. The 2018 criteria provide better prognostic stratification than the 2011 in patients with possible UIP. BAL fluid analysis can improve the diagnostic certainty for IPF diagnosis in patients with probable UIP CT pattern.
format article
author Jooae Choe
Byoung Soo Kwon
Kyung-Hyun Do
Hee Sang Hwang
Jin Woo Song
Eun Jin Chae
author_facet Jooae Choe
Byoung Soo Kwon
Kyung-Hyun Do
Hee Sang Hwang
Jin Woo Song
Eun Jin Chae
author_sort Jooae Choe
title Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
title_short Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
title_full Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
title_fullStr Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
title_full_unstemmed Diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
title_sort diagnostic and prognostic implications of 2018 guideline for the diagnosis of idiopathic pulmonary fibrosis in clinical practice
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/28c281b769bd4a858e9a094e9c9e4700
work_keys_str_mv AT jooaechoe diagnosticandprognosticimplicationsof2018guidelineforthediagnosisofidiopathicpulmonaryfibrosisinclinicalpractice
AT byoungsookwon diagnosticandprognosticimplicationsof2018guidelineforthediagnosisofidiopathicpulmonaryfibrosisinclinicalpractice
AT kyunghyundo diagnosticandprognosticimplicationsof2018guidelineforthediagnosisofidiopathicpulmonaryfibrosisinclinicalpractice
AT heesanghwang diagnosticandprognosticimplicationsof2018guidelineforthediagnosisofidiopathicpulmonaryfibrosisinclinicalpractice
AT jinwoosong diagnosticandprognosticimplicationsof2018guidelineforthediagnosisofidiopathicpulmonaryfibrosisinclinicalpractice
AT eunjinchae diagnosticandprognosticimplicationsof2018guidelineforthediagnosisofidiopathicpulmonaryfibrosisinclinicalpractice
_version_ 1718383982414921728

Ejemplares similares