ArticleAnnals of the American Thoracic Society2019
Differences between Patients in Whom Physicians Agree and Disagree about the Diagnosis of Acute Respiratory Distress Syndrome.
Article in Annals of the American Thoracic Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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20 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Electronic "Sniffer" Systems to Identify the Acute Respiratory Distress Syndrome.Annals of the American Thoracic Society · 2019Pooled it
- An Electronic Health Record-Based Classifier for Moderate-to-Severe Acute Respiratory Distress Syndrome With Persistent Hypoxemia.Critical care medicine · 2026Observational
- Length of stay, duration of mechanical ventilation, mortality, and acute kidney injury in acute respiratory failure requiring endotracheal intubation.World journal of critical care medicine · 2025Article
- Role of Attending Practice Variability in Prone Positioning Initiation: A Retrospective Cohort Study.CHEST critical care · 2025Article
- Incidence of diffuse parenchymal lung disease in patients meeting the Berlin definition of acute respiratory distress syndrome on mechanical ventilation.ERJ open research · 2025Article
- Multimodal Deep Learning for ARDS Detection.medRxiv : the preprint server for health sciences · 2025Article
- Lung Ultrasound Prediction Model for Acute Respiratory Distress Syndrome: A Multicenter Prospective Observational Study.American journal of respiratory and critical care medicine · 2023Observational
- Hospital Variation in Management and Outcomes of Acute Respiratory Distress Syndrome Due to COVID-19.Critical care explorations · 2022Article
- The impact of reduction in intensity of mechanical ventilation upon venovenous ECMO initiation on radiographically assessed lung edema scores: A retrospective observational study.Frontiers in medicine · 2022Article
- Comparing Clinical Features and Outcomes in Mechanically Ventilated Patients with COVID-19 and Acute Respiratory Distress Syndrome.Annals of the American Thoracic Society · 2021Article
- Biomarker-Based Classification of Patients With Acute Respiratory Failure Into Inflammatory Subphenotypes: A Single-Center Exploratory Study.Critical care explorations · 2021Article
- Validating Measures of Disease Severity in Acute Respiratory Distress Syndrome.Annals of the American Thoracic Society · 2021Article
- A novel swine model of the acute respiratory distress syndrome using clinically relevant injury exposures.Physiological reports · 2021Article
- The authors reply: Study selection for meta-analyses.The American journal of emergency medicine · 2021Article
- Learning Using Partially Available Privileged Information and Label Uncertainty: Application in Detection of Acute Respiratory Distress Syndrome.IEEE journal of biomedical and health informatics · 2021Article
- External Validation of an Acute Respiratory Distress Syndrome Prediction Model Using Radiology Reports.Critical care medicine · 2020Article
- Causes and characteristics of death in patients with acute hypoxemic respiratory failure and acute respiratory distress syndrome: a retrospective cohort study.Critical care (London, England) · 2020Article
- Clinician Recognition of the Acute Respiratory Distress Syndrome: Risk Factors for Under-Recognition and Trends Over Time.Critical care medicine · 2020Article
- The evolution of radiographic edema in ARDS and its association with clinical outcomes: A prospective cohort study in adult patients.Journal of critical care · 2020Observational
- Machine Learning Methods to Predict Acute Respiratory Failure and Acute Respiratory Distress Syndrome.Frontiers in big data · 2020Review
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5 authors at 3 institutions in 2 countries.
Funding
Abstract
rationaleBecause the Berlin definition of acute respiratory distress syndrome (ARDS) has only moderate reliability, physicians disagree about the diagnosis of ARDS in some patients. Understanding the clinical differences between patients with agreement and disagreement about the diagnosis of ARDS may provide insight into the epidemiology and pathophysiology of this syndrome, and inform strategies to improve the reliability of ARDS diagnosis.
objectivesTo characterize patients with diagnostic disagreement about ARDS among critical-care-trained physicians and compare them with patients with a consensus that ARDS developed.
methodsPatients with acute hypoxemic respiratory failure (arterial oxygen tension/pressure [Pa
resultsAmong 738 patients reviewed, 110 (15%) had consensus-ARDS, 100 (14%) had disagreement, and 528 (72%) did not have ARDS. ARDS diagnosis rates ranged from 9% to 47% across clinicians. Patients with disagreement had baseline comorbidity rates similar to those of patients with consensus-ARDS, but lower rates of ARDS risk factors and less severe measures of lung injury. Mean days of severe hypoxemia (Pa
conclusionsDisagreement about the diagnosis of ARDS is common and can be partly explained by the difficulty of dichotomizing patients along a continuous spectrum of ARDS manifestations. Considering both the presence of key ARDS risk factors and hypoxemia severity can help guide clinicians in identifying patients with diagnosis of ARDS agreed upon by a consensus of physicians.
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