Identification of progressive pulmonary fibrosis: consensus findings from a modified Delphi study
2024

Identifying Progressive Pulmonary Fibrosis

Sample size: 207 publication Evidence: moderate

Author Information

Author(s): Wells Athol U., Walsh Simon L. F., Adegunsoye Ayodeji, Cottin Vincent, Danoff Sonye K., Devaraj Anand, Flaherty Kevin R., George Peter M., Johannson Kerri A., Kolb Martin, Kondoh Yasuhiro, Nicholson Andrew G., Tomassetti Sara, Volkmann Elizabeth R., Brown Kevin K.

Primary Institution: Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust

Hypothesis

Can consensus be reached among respiratory physicians on the identification and monitoring of progression in patients with fibrosing interstitial lung disease?

Conclusion

The study established consensus statements on identifying ILD progression that may guide clinical practice until more robust guidelines are developed.

Supporting Evidence

  • Consensus was reached that a decline in FVC ≥ 10% from baseline indicates progression.
  • Decline in FVC, decline in DLco, and increased fibrosis on HRCT were ranked as the most important endpoints for determining progression.
  • Consensus was achieved that appropriate management of ILD depends on the type of ILD.
  • Physicians should follow up with patients with ILD every 3–6 months for the first two years.

Takeaway

Doctors worked together to agree on how to tell if lung disease is getting worse, which can help patients get better care.

Methodology

A modified Delphi process was used to gather consensus from respiratory physicians through surveys over three rounds.

Potential Biases

The study may be biased due to the lack of input from radiologists and histopathologists.

Limitations

Most respondents were pulmonologists from academic centers, and not all completed all survey rounds.

Participant Demographics

The majority of respondents were pulmonologists, with 98% working in academic centers.

Digital Object Identifier (DOI)

10.1186/s12931-024-03070-z

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication