Chronic Respiratory Disease最新文献

{"title":"Patient and healthcare professional perspectives on telehealth in the care of interstitial lung disease.","authors":"Sheetal Deshpande, Gabriella Tikellis, Hayley Barnes, Karen Symons, Anne E Holland, Ian Glaspole, Yet Hong Khor","doi":"10.1177/14799731251366945","DOIUrl":"10.1177/14799731251366945","url":null,"abstract":"<p><p>BackgroundWhile telehealth has been used for specialist care during the COVID-19 pandemic, its benefits and barriers to use for delivering care in interstitial lung disease (ILD) remain unclear. We aimed to explore perspectives of patients and healthcare professionals (HCPs) towards telehealth use in ILD.MethodThis qualitative study using semi-structured interviews was undertaken in 18 patients with ILD from a single quaternary ILD centre and 18 HCPs of four different disciplines from various ILD centres around Australia. Interviews were transcribed verbatim and coded by two investigators independently using thematic analysis. Themes were developed by consensus.ResultsPatients and HCPs had experienced telehealth via video and telephone, predominantly for teleconsultation and/or telerehabilitation. For patients, benefits included provision of ongoing access to healthcare and significant reduction in travel. Healthcare professionals reported teleconsultations played an important role in patient follow-up rather than at initial contact. Concerns of suboptimal rapport and communication and a lack of physical examination were raised by both groups. Individual patient suitability, improvement in technological platform and support, and improved workflow for clinicians were important factors for utilisation of telehealth. Patients were open to the use of home monitoring devices, however, HCPs felt further research was required prior to clinical implementation.ConclusionThis study highlights positive and negative experiences of telehealth for patients and HCPs in the management of ILD . It also identifies areas for improvement to create a tailored telehealth model for ILD care.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251366945"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eccentric cycling for chronic respiratory disease: Does helmet ventilation add value? A randomized controlled trial.","authors":"Ke-Yun Chao, Wei-Lun Liu, Hui-Wen Hsu, Hsin-Cheng Chen, Ai Yin Lim, Jong-Shyan Wang","doi":"10.1177/14799731251404870","DOIUrl":"10.1177/14799731251404870","url":null,"abstract":"<p><p>BackgroundChronic respiratory diseases frequently cause a decrease in physical activity and lower exercise tolerance. Eccentric Cycling Training (ECT) offers a potential rehabilitation strategy. However, its effectiveness when combined with Helmet Ventilation (HV) is not fully established.MethodsThis nonblinded randomized controlled trial (RCT) investigated the effects of ECT with or without HV in individuals with chronic respiratory diseases. Participants were randomly assigned to the ECT, ECT-HV, or control group and underwent graded exercise testing. The ECT sessions spanned 9 weeks with gradually increasing intensity. The primary outcome was peak oxygen consumption (VO_2peak). Secondary outcomes included functional tests and symptom scores.ResultsForty-four patients with chronic respiratory diseases were enrolled and divided among the ECT (n = 13), ECT-HV (n = 15), and control (n = 13) groups. After 9 weeks, significant improvements in the 6-min walk test (6MWT) distance, energy expenditure index during the 6MWT, and timed up and go test were observed in both the ECT and ECT-HV groups compared to the control group. Reductions in initially high Borg leg fatigue were noted over time in these groups. VO_2peak at follow-up was 17.6 ± 2.9 ml/min/kg in the control group, 17.2 ± 4.5 ml/min/kg in the ECT group, and 18.2 ± 3.9 ml/min/kg in the ECT-HV group, with no significant differences among groups. No significant differences in achieving the targeted exercise intensity were found between the ECT and ECT-HV groups.ConclusionsOver a 9-week period, eccentric cycling training improved functional capacity and mobility in patients with chronic respiratory diseases, although no significant changes were observed in peak oxygen consumption or overall cardiopulmonary fitness.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251404870"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote assessment of exercise capacity in adults with chronic respiratory disease: Safety, reliability and acceptability.","authors":"Narelle S Cox, Simone Dal Corso, Angela T Burge, Janet Bondarenko, Jaycie Perryman, Anne E Holland","doi":"10.1177/14799731251318033","DOIUrl":"10.1177/14799731251318033","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the safety, reliability and acceptability of the modified incremental step test (MIST) supervised remotely via videoconferencing in adults with chronic respiratory disease.</p><p><strong>Methods: </strong>Adults with chronic respiratory disease undertaking pulmonary rehabilitation were invited to undertake the MIST under two testing conditions: in-person supervision and remote supervision via video-conferencing. Test order was randomised.</p><p><strong>Results: </strong>38 participants (<i>n</i> = 18 Female; mean (SD) age 68 (10) years; 56% chronic obstructive pulmonary disease) undertook two MIST evaluations. There was excellent agreement between tests for total step count (ICC_2,1 0.93, 95%CI 0.86 to 0.96), despite higher counts with in-person supervision (MD 12 steps, 95%CI 1 to 24). There was very good agreement, and no difference between tests, for nadir oxygen saturation (ICC_2,1 0.797, 95%CI 0.643 to 0.889) and peak heart rate (ICC_2,1 0.782, 95%CI 0.620 to 0.880). Participant satisfaction with telehealth was high, and confidence was not different between testing conditions. There were no adverse events and remote testing was acceptable to participants.</p><p><strong>Discussion: </strong>In this single centre cohort study MIST supervised remotely via video-conferencing was safe, reliable and acceptable to people with chronic respiratory disease.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251318033"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are the important components of physical activity for people with fibrotic interstitial lung disease?","authors":"Mariana Hoffman, Christie R Mellerick, Angela T Burge, Anne E Holland","doi":"10.1177/14799731251358584","DOIUrl":"10.1177/14799731251358584","url":null,"abstract":"<p><p>IntroductionFibrotic interstitial lung disease (fILD) is characterized by scarring of the lungs, decline in lung function and compromised exercise capacity. People with fILD participate in less daily physical activity compared to healthy controls, however, the relative importance of physical activity components (volume, intensity, duration) is unknown. This study aimed to examine the relationship between the components of physical activity and established disease severity and impact measures in fILD.MethodsParticipant data were from baseline assessment of a randomized controlled trial recruiting people with fILD and exertional desaturation during exercise testing on room air. Physical activity components including volume (steps per day), intensity (light, moderate and vigorous) and duration (time spent in different physical activity intensities) were objectively assessed for 7 days using two physical activity monitors. Associations of these components with lung function (FVC, FEV₁, TLCO), functional exercise capacity (6-min walk distance, 6MWD) and dyspnea (Dyspnea-12 questionnaire) were investigated.Results106 participants with mild to severe fILD were included. Physical activity volume was not associated with 6MWD (r = 0.027, <i>p</i> = 0.78) and weakly associated with lung function (FVC r = 0.33, <i>p</i> = 0.001; FEV₁ r = 0.34, <i>p</i> = 0.001). Physical activity intensity and duration were weakly associated with 6MWD (light r = 0.22 <i>p</i> = 0.02; moderate r = 0.42, <i>p</i> < 0.001; vigorous r = 0.33, <i>p</i> = 0.01). Time spent in vigorous physical activity was weakly associated with lung function (FVC r = 0.19, <i>p</i> = 0.05; FEV₁ r = 0.18, <i>p</i> = 0.006). Dyspnea scores were not associated with any physical activity variables. Relationships remained consistent after adjusting for age, gender and disease severity, with the exception of vigorous physical activity which was no longer associated with lung function or 6MWD.ConclusionIn people with fILD, the physical activity components of volume, intensity and duration were associated with different measures of disease severity and impact. This highlights the importance of considering specific physical activity components when evaluating and promoting physical activity in this group.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251358584"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Aspergillus</i> IgG antibody testing in the diagnosis of hypersensitivity pneumonitis: A scoping review.","authors":"Lana Hatim, David W Denning","doi":"10.1177/14799731251326592","DOIUrl":"10.1177/14799731251326592","url":null,"abstract":"<p><p>BackgroundDiagnosis of hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis requires a combination of tests with antibody testing playing a supportive role to identify exposures.ObjectivesWe conducted a scoping review on <i>Aspergillus</i> antibody testing in <i>Aspergillus</i>-related HP to identify the utility and diagnostic cutoffs proposed in the literature. We compared these cutoffs with studies of chronic pulmonary aspergillosis (CPA) and manufacturers' cutoffs.Eligibility criteriaOnly studies addressing the diagnostic value of <i>Aspergillus</i> IgG or precipitins for HP were included. Separately papers defining cutoffs for CPA were tabulated.Sources of evidencePublished papers were identified in literature searches in Embase, Web of Science, and Medline.ResultsWe identified 414 papers, of which 12 were included, all published between 1965 and 2005. Occupational HP linked to <i>Aspergillus</i> spp. exposure included Farmer's Lung, Malt-Worker's Lung, Esparto Worker's Lung, and Woodworker's lung (Sawmill-workers). No studies directly addressed serological testing in Tobacco Worker's lung, Compost Lung, or poultry workers. Among <i>Aspergillus</i> species exposure, <i>A. fumigatus</i> was most commonly described; others included <i>A. umbrosus</i> (now <i>A. glaucus</i>), <i>A. clavatus</i>, and <i>A. niger</i>. Antibody tests included ELISA, BALISA, precipitin tests and ImmunoCAP, with a higher sensitivity of ELISA and ImmunoCAP tests compared to precipitin tests. Patients with HP linked to <i>Aspergillus</i> exposures, were positive in 156/290 (53.8%) compared to 96/615 (15.6%) in those with similar occupational exposures without HP. In malt workers with HP 35/53 (66%) had detectable <i>A.</i> <i>clavatus</i> IgG antibody compared to 0/53 <i>A. fumigatus</i> IgG, and 13/74 (18%) exposed but unaffected workers, but are not commercially available.ConclusionsImproved means of establishing or ruling out <i>Aspergillus</i> exposure are required, given the negative consequences for patients of continued <i>Aspergillus</i> inhalation. Modern studies with commercially available <i>Aspergillus</i> IgG antibody assays are required to define appropriate cutoffs for HP, given numerous studies published for chronic pulmonary aspergillosis.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251326592"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of home-based pulmonary rehabilitation for individuals with idiopathic pulmonary fibrosis in Delhi, India.","authors":"Humaira Hanif, Obaidullah Ahmed, James R Manifield, Mohd Shibli, Amy Barradell, Zahira Ahmed, Dominic Malcolm, Andy Barton, Deepak Talwar, Mark W Orme, Sally J Singh","doi":"10.1177/14799731251375043","DOIUrl":"10.1177/14799731251375043","url":null,"abstract":"<p><p>ObjectivesTo determine the feasibility and acceptability of home-based pulmonary rehabilitation (HBPR) for individuals with idiopathic pulmonary fibrosis (IPF).MethodsIn this single-arm feasibility trial, individuals with IPF were recruited from Delhi, India, to a 6-weeks HBPR programme using a paper-based manual. Primary outcomes were feasibility (classified by ≥60% of eligible patients recruited and ≥70% of recruited patients completing the follow-up assessment) and intervention acceptability (semi-structured interviews).ResultsOut of 42 screened, 36 individuals were eligible (86% of screened), and 30 were recruited (83% of eligible, 71% of screened; 60 ± 13 years, 53% female), with 25 completing their follow-up assessment (83% of recruited). HBPR was generally well-accepted, with qualitative themes including: 'facilitators and barriers to HBPR' (family support and flexibility of home environment were facilitators whereas lack of supervision and inability to follow a routine were barriers), 'perceived changes from taking part in HBPR' (improved exercise capacity, breathlessness, and independency), and 'how to improve HBPR in the future' (translating the manual into various languages, and incorporating into a more hybrid approach).ConclusionHBPR using a paper-based manual was feasible and acceptable, potentially suitable for improving the uptake and completion of PR for individuals with IPF in Delhi, India.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251375043"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of Peptest™ combined with gastroesophageal reflux disease questionnaire in identifying patients with gastroesophageal reflux-induced chronic cough.","authors":"Jiaying Yuan, Xiao Luo, Lina Huang, Yaxing Zhou, Bingxian Sha, Tongyangzi Zhang, Shengyuan Wang, Li Yu, Xianghuai Xu","doi":"10.1177/14799731251364875","DOIUrl":"10.1177/14799731251364875","url":null,"abstract":"<p><p>ObjectivesGastroesophageal reflux-related chronic cough (GERC), an extraesophageal manifestation of gastroesophageal reflux disease (GERD). Although 24h MII-pH monitoring is the gold standard for diagnosing GERC, its invasiveness, high cost, and limited accessibility hinder widespread use in many clinical settings. This study aimed to develop a non-invasive machine learning model incorporating Peptest™ and GerdQ scores to facilitate GERC detection, particularly in primary care and resource-limited environments where MII-pH testing is not readily available.Methods210 chronic cough patients were enrolled between September 2022 and June 2024. GERC diagnosis followed established guidelines, and salivary pepsin levels were measured via Peptest™. Feature selection was performed using the Boruta algorithm (hereafter referred to as Boruta), a method based on random forest (RF), designed to identify relevant variables by comparing them to random shadow features. The selected optimal features were then evaluated using nine ML models, including logistic regression (LR), RF and others. Model performance was assessed through area under the curve (AUC), decision curve analysis (DCA), and calibration curves.Results73 (34.76%) patients had GERC. Peptest™ and GerdQ scores were key predictors. Logistic regression was selected for its balance of accuracy (AUC: 0.876) and clinical utility. The nomogram model showed excellent discrimination and calibration. DCA indicated high net benefit at prediction thresholds of 0.10-0.90. RCS analysis revealed non-linear relationships: GERC risk increased with GerdQ >8.66 and Peptest™ >54.791 ng/ml.ConclusionThe nomogram model provides a reliable, non-invasive tool for GERC diagnosis, aiding timely clinical intervention, especially for patients unsuitable for pH testing.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251364875"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional status in COPD: Comparison with healthy controls and impact of an exacerbation.","authors":"Fien Hermans, Eva Arents, Astrid Blondeel, Nina Cardinaels, Wim Janssens, Thierry Troosters, Eric Derom, Heleen Demeyer","doi":"10.1177/14799731251358593","DOIUrl":"10.1177/14799731251358593","url":null,"abstract":"<p><p>BackgroundFunctional status is a marker for evaluating fall risk and predicting mortality and hospitalisations in elderly and patients with COPD. Acute exacerbations of COPD result in sudden declines in exercise capacity, quadriceps force (QF) and physical activity (PA), but their impact on functional status remains unclear. This study aimed to (i) compare the functional status of patients with COPD to healthy controls and (ii) assess prospectively the impact of an exacerbation on functional status.MethodsHealthy controls and patients were assessed. Patients were followed up every 6 months and were tested again immediately if they reported an exacerbation. The short physical performance battery (SPPB), timed up and go test (TUG), 1-minute sit-to-stand test (1MSTS), 6-minute walking distance (6MWD), QF and PA (accelerometery) were measured.ResultsThirty-six patients (69 ± 7 years, 69% male) and 25 matched healthy controls (68 ± 7 years, 80% male) were included. Functional status was decreased in patients compared to healthy controls. Twelve patients were retested 10 ± 7 days after a moderate (n = 11) or severe (n = 1) exacerbation. The 1MSTS (∆-3 ± 3repetitions, p < 0.0001), 6MWD (∆-34 ± 46m, p < 0.0001) and QF (∆-9 ± 13Nm, p = 0.05) decreased after exacerbation onset. No changes in SPPB and PA were observed.ConclusionAn exacerbation negatively impacts the already reduced functional status in patients with COPD. The SPPB is not able to capture this decline.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251358593"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The order of completing MDP and D12 does not affect the breathlessness responses: A randomised controlled trial.","authors":"Isabelle Wemar, Jacob Sandberg, Max Olsson, Josefin Sundh, Magnus Ekström","doi":"10.1177/14799731251393985","DOIUrl":"10.1177/14799731251393985","url":null,"abstract":"<p><p>BackgroundBreathlessness is a common and distressing symptom across a wide range of medical conditions. Different aspects (dimensions) of breathlessness can be assessed using the Multidimensional Dyspnoea Profile (MDP) and Dyspnoea-12 (D12) questionnaires. We aimed to examine whether the order of completing MDP and D12 affects the breathlessness responses in people with cardiorespiratory disease.MethodsThis was a randomised controlled trial embedded within a longitudinal clinical study. Outpatients with cardiorespiratory disease were randomly assigned to either first complete the MDP or the D12. Primary outcome was mean difference in D12 total score between groups, secondary outcome was mean difference in D12 and MDP subdomain scores. Both outcomes were compared to the minimal clinically important difference (MCID) for each scale.ResultsAll 182 participants from the longitudinal study were included. 93 were randomized to complete MDP first and 89 to D12 first. Characteristics such as age, sex, main cause of breathlessness and smoking status were similar between groups. The mean difference for D12 total score (MCID = 2.8) was -1.5 (-4.2 to 1.3, <i>p</i> = 0.26) between groups. Mean differences between groups in subdomain scores were also below the corresponding MCID.ConclusionThe order of completion of MDP and D12 did not impact the scores significantly, but the study lacked power to find smaller yet clinically significant differences. The study supports that the most practical order of completing the instruments can be used in future research and in clinical settings.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251393985"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12576214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connective tissue disease-associated interstitial lung disease risk of readmission and all-cause mortality: Interpretable machine learning approach.","authors":"Boyi Chen, Xixian Hu, Xuefei Shi, Bin Wang","doi":"10.1177/14799731251409756","DOIUrl":"10.1177/14799731251409756","url":null,"abstract":"<p><p>ObjectiveConnective tissue disease (CTD) encompasses a group of autoimmune disorders, with interstitial lung disease (ILD) being the most common form of pulmonary involvement. The primary focus of this study was to employ machine learning for the identification of blood-based biomarkers in individuals afflicted with CTD-ILD. Additionally, the study aimed to assess the potential association of these biomarkers with the likelihood of hospital readmissions and all-cause mortality within a 1-year period among CTD-ILD patients.MethodsA total of 210 patients were included in the study, with 147 patients allocated to the training set and 63 patients assigned to the test set. Univariate logistic regression, LASSO regression, and multivariable logistic regression analyses were executed to discern the risk factors associated with readmission within 1 year among CTD-ILD. Logistic regression, support vector machine, and XGBoost were utilized to build the model. The global and local interpretation of the model was conducted using SHAP. The efficacy of model was evaluated using the ROC curve and DCA. Furthermore, the predictive values of inflammatory indicators were compared for their ability to forecast all-cause mortality in CTD-ILD patients.ResultsLow albumin levels, high CA125, and CYFRA 21-1 were identified as significant factors associated with patient readmissions. The XGBoost model demonstrated the highest efficacy in both the training and test sets, achieving an AUC of 0.857 (95% CI 0.832-0.879) and 0.788 (95% CI 0.706-0.833), respectively. SHAP analysis indicated that low albumin had the most significant impact on the model outcomes. Among the 1-year all-cause deaths of CTD-ILD patients, the neutrophil-to-lymphocyte ratio (NLR) was the most potent predictor in univariate analysis. A model combining albumin, CA125, and CYFRA 21-1 with NLR was constructed, achieving an AUC of 0.944 (95% CI 0.915-0.964).ConclusionElevated levels of CA125, CYFRA 21-1, and NLR, along with lower albumin levels, were predictive of a poor prognosis in CTD-ILD patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251409756"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12722688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}