Detection and Early Referral of Patients With Interstitial Lung Abnormalities: An Expert Survey Initiative.
Detection and Early Referral of Patients With Interstitial Lung Abnormalities: An Expert Survey Initiative.
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DOI：
10.1016/j.chest.2021.06.035
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发表时间：
2022-02
期刊：
影响因子：
9.6
通讯作者：
White, Eric S.
中科院分区：
文献类型：
--
作者：
Hunninghake, Gary M.;Goldin, Jonathan G.;Kadoch, Michael A.;Kropski, Jonathan A.;Rosas, Ivan O.;Wells, Athol U.;Yadav, Ruchi;Lazarus, Howard M.;Abtin, Fereidoun G.;Corte, Tamera J.;de Andrade, Joao A.;Johannson, Kerri A.;Kolb, Martin R.;Lynch, David A.;Oldham, Justin M.;Spagnolo, Paolo;Strek, Mary E.;Tomassetti, Sara;Washko, George R.;White, Eric S.
间质性肺异常（ILA）可能代表未诊断的早期或亚临床间质性肺疾病（ILD）。ILA通常在随后发生临床明显ILD的患者中偶然观察到。关于国际法协会的共识定义和适当评价的信息有限。ILD患者的早期识别仍然具有挑战性，但至关重要。专家共识可以为早期识别和转诊提供信息。是否可以确定基于共识的专家建议，以指导临床医生识别、转诊和随访早期ILD患者或有发展风险的患者？具有ILD专业知识的肺科医生和放射科医生参与了两轮迭代调查。这些调查旨在就ILA报告、ILA患者的识别以及可能从ILD筛查中获益的人群的识别建立共识。还讨论了建议的转诊标准和后续程序。共识阈值先验定义为≥ 75%的一致或不一致。邀请了55名专家，44名专家参加;就85个问题中的39个达成了共识。以下具有临床意义的声明达成共识：蜂窝样和牵拉性支气管扩张或细支气管扩张提示可能进行性ILD;肺癌筛查期间检测到的蜂窝样应报告为可能显著（例如，使用肺部CT筛查报告和数据系统“S-修改器”[Lung-RADS;其指示临床显著或潜在显著的非癌症发现]），在放射学报告中建议转诊至肺病专家;如果在CT成像上观察到非依赖性胸膜下网状影、牵拉性支气管扩张、蜂窝样改变、小叶中心磨玻璃样结节或斑片状磨玻璃样阴影，则应安排高分辨率CT成像和完整的肺功能检查;蜂窝样改变或牵拉性支气管扩张患者应转诊至肺科医生，无论弥散量值如何;系统性硬化症患者应进行肺功能检查以筛查早期ILD。制定了识别临床相关ILA、后续转诊和随访的指南。这些结果为制定管理ILA患者的实用指南奠定了基础。
Interstitial lung abnormalities (ILA) may represent undiagnosed early-stage or subclinical interstitial lung disease (ILD). ILA are often observed incidentally in patients who subsequently develop clinically overt ILD. There is limited information on consensus definitions for, and the appropriate evaluation of, ILA. Early recognition of patients with ILD remains challenging, yet critically important. Expert consensus could inform early recognition and referral. Can consensus-based expert recommendations be identified to guide clinicians in the recognition, referral, and follow-up of patients with or at risk of developing early ILDs? Pulmonologists and radiologists with expertise in ILD participated in two iterative rounds of surveys. The surveys aimed to establish consensus regarding ILA reporting, identification of patients with ILA, and identification of populations that might benefit from screening for ILD. Recommended referral criteria and follow-up processes were also addressed. Threshold for consensus was defined a priori as ≥ 75% agreement or disagreement. Fifty-five experts were invited and 44 participated; consensus was reached on 39 of 85 questions. The following clinically important statements achieved consensus: honeycombing and traction bronchiectasis or bronchiolectasis indicate potentially progressive ILD; honeycombing detected during lung cancer screening should be reported as potentially significant (eg, with the Lung CT Screening Reporting and Data System “S-modifier” [Lung-RADS; which indicates clinically significant or potentially significant noncancer findings]), recommending referral to a pulmonologist in the radiology report; high-resolution CT imaging and full pulmonary function tests should be ordered if nondependent subpleural reticulation, traction bronchiectasis, honeycombing, centrilobular ground-glass nodules, or patchy ground-glass opacity are observed on CT imaging; patients with honeycombing or traction bronchiectasis should be referred to a pulmonologist irrespective of diffusion capacity values; and patients with systemic sclerosis should be screened with pulmonary function tests for early-stage ILD. Guidance was established for identifying clinically relevant ILA, subsequent referral, and follow-up. These results lay the foundation for developing practical guidance on managing patients with ILA.
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影响因子：
10
作者：
Kolb M;Richeldi L;Behr J;Maher TM;Tang W;Stowasser S;Hallmann C;du Bois RM
通讯作者：
du Bois RM
DOI：
10.1056/nejmoa1216076
发表时间：
2013-06-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hunninghake GM;Hatabu H;Okajima Y;Gao W;Dupuis J;Latourelle JC;Nishino M;Araki T;Zazueta OE;Kurugol S;Ross JC;San José Estépar R;Murphy E;Steele MP;Loyd JE;Schwarz MI;Fingerlin TE;Rosas IO;Washko GR;O'Connor GT;Schwartz DA
通讯作者：
Schwartz DA
DOI：
10.1164/rccm.201903-0511oc
发表时间：
2019-12-01
影响因子：
24.7
作者：
Hobbs, Brian D.;Putman, Rachel K.;Viviano, Lisa
通讯作者：
Viviano, Lisa
影响因子：
158.5
作者：
Distler, Oliver;Highland, Kristin B.;Maher, Toby M.
通讯作者：
Maher, Toby M.
DOI：
10.1164/rccm.201406-1162oc
发表时间：
2015-02-15
影响因子：
24.7
作者：
Kropski, Jonathan A.;Pritchett, Jason M.;Blackwell, Timothy S.
通讯作者：
Blackwell, Timothy S.