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- Title
Systemic sclerosis associated interstitial lung disease: a conceptual framework for subclinical, clinical and progressive disease.
- Authors
Roofeh, David; Brown, Kevin K; Kazerooni, Ella A; Tashkin, Donald; Assassi, Shervin; Martinez, Fernando; Wells, Athol U; Raghu, Ganesh; Denton, Christopher P; Chung, Lorinda; Hoffmann-Vold, Anna-Maria; Distler, Oliver; Johannson, Kerri A; Allanore, Yannick; Matteson, Eric L; Kawano-Dourado, Leticia; Pauling, John D; Seibold, James R; Volkmann, Elizabeth R; Walsh, Simon L F
- Abstract
Objectives To establish a framework by which experts define disease subsets in systemic sclerosis associated interstitial lung disease (SSc-ILD). Methods A conceptual framework for subclinical, clinical and progressive ILD was provided to 83 experts, asking them to use the framework and classify actual SSc-ILD patients. Each patient profile was designed to be classified by at least four experts in terms of severity and risk of progression at baseline; progression was based on 1-year follow-up data. A consensus was reached if ≥75% of experts agreed. Experts provided information on which items were important in determining classification. Results Forty-four experts (53%) completed the survey. Consensus was achieved on the dimensions of severity (75%, 60 of 80 profiles), risk of progression (71%, 57 of 80 profiles) and progressive ILD (60%, 24 of 40 profiles). For profiles achieving consensus, most were classified as clinical ILD (92%), low risk (54%) and stable (71%). Severity and disease progression overlapped in terms of framework items that were most influential in classifying patients (forced vital capacity, extent of lung involvement on high resolution chest CT [HRCT]); risk of progression was influenced primarily by disease duration. Conclusions Using our proposed conceptual framework, international experts were able to achieve a consensus on classifying SSc-ILD patients along the dimensions of disease severity, risk of progression and progression over time. Experts rely on similar items when classifying disease severity and progression: a combination of spirometry and gas exchange and quantitative HRCT.
- Subjects
DISEASE progression; CONSENSUS (Social sciences); CONFIDENCE intervals; SYSTEMIC scleroderma; INTERSTITIAL lung diseases; CONCEPTUAL structures; SEVERITY of illness index; DESCRIPTIVE statistics; CHI-squared test; RESEARCH funding; EVALUATION
- Publication
Rheumatology, 2023, Vol 62, Issue 5, p1877
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/keac557