Identification and management of connective tissue disease-associated interstitial lung disease: evidence-based Japanese consensus statements.

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-01-01 Epub Date: 2023-02-20 DOI:10.1080/17476348.2023.2176303
Masataka Kuwana, Masashi Bando, Yutaka Kawahito, Shinji Sato, Takafumi Suda, Yasuhiro Kondoh
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Abstract

Background: Interstitial lung disease (ILD) is a common complication of connective tissue diseases (CTD), but there are few clinical trials to guide disease management. We aimed to develop expert consensus statements and an algorithm for CTD-ILD management.

Research design and methods: Based on a targeted literature review, we developed 109 statements on managing CTD-ILD across six domains. We used a modified Delphi process to survey 22 physicians in Japan involved in managing CTD-ILD (specialists in pulmonology, rheumatology, pathology, and radiology). These panelists participated in two rounds of web-based survey to establish consensus statements, which were used to define an algorithm. Consensus was defined as a mean value ≥70 on a scale of 0 (strong disagreement) to 100 (strong agreement).

Results: Between May-August 2022, consensus was reached on 93 statements on CTD-ILD management. The most important consensus statements included screening CTD patients for ILD (typically with high-resolution computed tomography), using imaging, pulmonary function testing and serum biomarkers for diagnosis and severity assessment, regularly following up patients, and multidisciplinary management of CTD-ILD. Consensus statements were interpreted into an algorithm for clinical guidance.

Conclusions: Using the Delphi process, we have developed consensus statements and an algorithm to guide clinical decision-making for CTD-ILD.

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结缔组织病相关间质性肺病的识别与管理:循证日本共识声明。
背景:间质性肺病(ILD)是结缔组织病(CTD)的常见并发症,但指导疾病管理的临床试验却很少。我们旨在制定专家共识声明和 CTD-ILD 管理算法:根据有针对性的文献综述,我们制定了 109 份关于 CTD-ILD 管理的声明,涉及六个领域。我们采用改良德尔菲法对日本 22 名参与 CTD-ILD 管理的医生(肺病学、风湿病学、病理学和放射学专家)进行了调查。这些专家小组成员参加了两轮网络调查,以确定共识声明,并用于定义算法。共识的定义是,在0(非常不同意)到100(非常同意)的范围内,平均值≥70:结果:2022 年 5 月至 8 月间,就 93 项 CTD-ILD 管理声明达成了共识。最重要的共识包括对 CTD 患者进行 ILD 筛查(通常使用高分辨率计算机断层扫描),使用影像学、肺功能检测和血清生物标志物进行诊断和严重程度评估,定期随访患者,以及 CTD-ILD 的多学科管理。共识声明被解释为一种用于临床指导的算法:通过德尔菲法,我们制定了共识声明和算法,用于指导 CTD-ILD 的临床决策。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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