RT Journal Article
SR Electronic
T1 A diagnostic model for chronic hypersensitivity pneumonitis
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 951
OP 954
DO 10.1136/thoraxjnl-2016-208286
VO 71
IS 10
A1 Kerri A Johannson
A1 Brett M Elicker
A1 Eric Vittinghoff
A1 Deborah Assayag
A1 Kaïssa de Boer
A1 Jeffrey A Golden
A1 Kirk D Jones
A1 Talmadge E King, Jr
A1 Laura L Koth
A1 Joyce S Lee
A1 Brett Ley
A1 Paul J Wolters
A1 Harold R Collard
YR 2016
UL http://thorax.bmj.com/content/71/10/951.abstract
AB The objective of this study was to develop a diagnostic model that allows for a highly specific diagnosis of chronic hypersensitivity pneumonitis using clinical and radiological variables alone. Chronic hypersensitivity pneumonitis and other interstitial lung disease cases were retrospectively identified from a longitudinal database. High-resolution CT scans were blindly scored for radiographic features (eg, ground-glass opacity, mosaic perfusion) as well as the radiologist's diagnostic impression. Candidate models were developed then evaluated using clinical and radiographic variables and assessed by the cross-validated C-statistic. Forty-four chronic hypersensitivity pneumonitis and eighty other interstitial lung disease cases were identified. Two models were selected based on their statistical performance, clinical applicability and face validity. Key model variables included age, down feather and/or bird exposure, radiographic presence of ground-glass opacity and mosaic perfusion and moderate or high confidence in the radiographic impression of chronic hypersensitivity pneumonitis. Models were internally validated with good performance, and cut-off values were established that resulted in high specificity for a diagnosis of chronic hypersensitivity pneumonitis.