TY - JOUR
T1 - Interstitial lung disease in India results of a prospective registry
AU - Singh, Sheetu
AU - Collins, Bridget F.
AU - Sharma, Bharat B.
AU - Joshi, Jyotsna M.
AU - Talwar, Deepak
AU - Katiyar, Sandeep
AU - Singh, Nishtha
AU - Ho, Lawrence
AU - Samaria, Jai Kumar
AU - Bhattacharya, Parthasarathi
AU - Gupta, Rakesh
AU - Chaudhari, Sudhir
AU - Singh, Tejraj
AU - Moond, Vijay
AU - Pipavath, Sudhakar
AU - Ahuja, Jitesh
AU - Chetambath, Ravindran
AU - Ghoshal, Aloke G.
AU - Jain, Nirmal K.
AU - Gayathri Devi, H. J.
AU - Kant, Surya
AU - Koul, Parvaiz
AU - Dhar, Raja
AU - Swarnakar, Rajesh
AU - Sharma, Surendra K.
AU - Roy, Dhrubajyoti J.
AU - Sarmah, Kripesh R.
AU - Jankharia, Bhavin
AU - Schmidt, Rodney
AU - Katiyar, Santosh K.
AU - Jindal, Arpita
AU - Mangal, Daya K.
AU - Singh, Virendra
AU - Raghu, Ganesh
N1 - Publisher Copyright:
© 2017 by the American Thoracic Society.
PY - 2017/3/15
Y1 - 2017/3/15
N2 - Rationale: Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India. Objectives: To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses. Methods: Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities,March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: Local site investigators, ILD experts at the National Data Coordinating Center(NDCC;Jaipur, India)withMDD,and experienced ILDexperts at the Center for ILD (CILD; Seattle, WA) withMDD. Cohen's k was used to assess reliability of interobserver agreement. Measurements and Main Results: A total of 1,084 patients were recruited. Final diagnosis: Hypersensitivity pneumonitis in 47.3%(n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's k: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD. Conclusions: Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide.
AB - Rationale: Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India. Objectives: To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses. Methods: Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities,March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: Local site investigators, ILD experts at the National Data Coordinating Center(NDCC;Jaipur, India)withMDD,and experienced ILDexperts at the Center for ILD (CILD; Seattle, WA) withMDD. Cohen's k was used to assess reliability of interobserver agreement. Measurements and Main Results: A total of 1,084 patients were recruited. Final diagnosis: Hypersensitivity pneumonitis in 47.3%(n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's k: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD. Conclusions: Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide.
KW - India
KW - Interstitial lung disease
KW - Registry
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U2 - 10.1164/rccm.201607-1484OC
DO - 10.1164/rccm.201607-1484OC
M3 - Article
C2 - 27684041
AN - SCOPUS:85015888404
SN - 1073-449X
VL - 195
SP - 801
EP - 813
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 6
ER -