Table 2

Key findings in interstitial lung abnormalities, important missing information and action items

Key findingsGoalMissing informationAction items
Interstitial lung abnormalities (a diverse set of chest CT imaging findings suggestive of an underlying interstitial lung disease) are relatively common in older adults and are associated with adverse outcomes.To develop radiological standards on reporting interstitial abnormalities.Do specific imaging findings help predict progression and adverse outcomes in those with interstitial abnormalities?Studies should focus on trying to identify if specific radiological features and patterns help predict adverse outcomes in those with interstitial abnormalities.
Studies of physiological and histopathological data suggest that some people with interstitial abnormalities have an early stage of pulmonary fibrosis.To develop consensus statements on when an imaging abnormality constitutes a disease in an undiagnosed and asymptomatic person.Can consensus on updated disease definitions be achieved?Committees should be developed so that evidence-based consensus guidelines and position statements from major societies could be generated and updated when appropriate.
Some groups appear to be at an increased risk to develop interstitial abnormalities.To develop effective screening programmes in high-risk groups.What are the results of early pulmonary fibrosis screening studies? What groups are interested in participating in these types of studies?In addition to encouraging publication from studies actively participating in screening efforts, funding agencies should consider encouraging these efforts so that populations for secondary prevention trials can be developed.
Antifibrotic therapy slows lung function decline in patients with IPF, even among those more preserved measures of pulmonary function.To conduct secondary prevention trials in patients with early stages of pulmonary fibrosis.What groups with interstitial abnormalities would benefit the most from early therapeutic intervention? Are there secondary endpoints thatĀ help predict longer term outcomes in those with interstitial abnormalities?Early discussions should be undertaken to consider how to define reasonable endpoints and how to appropriately power trials in those with early stages of pulmonary fibrosis.
  • IPF, idiopathic pulmonary fibrosis.