Clinical utility of a standardized chronic hypersensitivity pneumonitis exposure questionnaire.
Clinical utility of a standardized chronic hypersensitivity pneumonitis exposure questionnaire.
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标准化慢性过敏性肺炎暴露调查问卷的临床实用性。
DOI：
10.1111/resp.14404
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Glaspole,Ian
中科院分区：
文献类型：
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作者：
Barnes,Hayley;Chambers,Daniel;Grainge,Chris;Corte,TameraJ;Bastiampillai,Shalini;Frenkel,Simon;Westall,Glen;Collard,Harold;Glaspole,Ian
背景和结论暴露的识别是慢性过敏性肺炎（CHP）诊断、管理和鉴别的组成部分。标准化问卷可能有助于识别暴露，但是，目前没有基于证据的患者验证问卷可用。表明暴露相关性的关键限定词（包括持续时间和频率）也定义不清。本研究评估了使用一个标准化的CHP暴露问卷在识别的暴露和诊断的信心CHP.MethodsPeople与多学科会议（MDM）诊断从五个澳大利亚间质性肺病（ILD）专家中心提供知情同意书。参与者完成了先前制定的标准化CHP暴露问卷。响应收集与参与者的MDM数据，包括诊断，诊断信心，和临床医生引起的exposs.Results130参与者（IPF = 58，CHP = 24，CTD-ILD = 17，不可分类= 19，其他= 12）。在33%的CHP参与者中，标准化问卷引起了临床医生没有的暴露。其中63%的人有临时低置信度CHP;暴露史会增加这些病例的诊断置信度。使用标准化问卷，96%的CHP参与者报告了任何暴露，而非HP ILD参与者为75%。CHP参与者的可能性是（p= 0.004）报告他们的症状改善回避，和2.3倍的可能性（p= 0.018）报告每日频繁暴露，结论一个标准化的问卷调查，除了有或没有相关的暴露，还可以增加CHP的诊断信心，减少抗原不确定的CHP。
Background and ObjectiveIdentification of an exposure is integral to the diagnosis, management, and prognostication of chronic hypersensitivity pneumonitis (CHP). Standardized questionnaires may aid in the identification of exposures, however, there currently are no evidence‐based patient‐validated questionnaires available. Key qualifiers (including duration and frequency) which indicate exposure relevance are also poorly defined. This study assessed the use of a standardized CHP exposure questionnaire in the identification of exposures and diagnostic confidence of CHP.MethodsPeople with a multi‐disciplinary meeting (MDM) diagnosis from five Australian interstitial lung disease (ILD) expert centres who provided informed consent were included. Participants completed a previously developed standardized CHP Exposure Questionnaire. Responses were collected with the participant's MDM data, including diagnosis, diagnostic confidence, and clinician‐elicited exposures.ResultsOne hundred thirty participants (IPF = 58, CHP = 24, CTD‐ILD = 17, unclassifiable = 19, other = 12) were included. In 33% of CHP participants, a standardized questionnaire elicited an exposure where the clinician did not. 63% of these had provisional low confidence CHP; and an exposure history would have increased the diagnostic confidence in these cases. Using the standardized questionnaire, 96% of CHP participants reporting any exposure, compared with 75% of non‐HP ILD participants. CHP participants were 3.5 times more likely (p= 0.004) to report their symptoms improved on avoidance, and 2.3 times more likely (p= 0.018) to report daily frequent exposure, compared with non‐HP ILDs.ConclusionA standardized questionnaire which elicits exposure characteristics in addition to presence or absence of relevant exposures can increase the diagnostic confidence of CHP and reduce the proportion of antigen‐indeterminate CHP.