SynthesisChest2020
A Systematically Derived Exposure Assessment Instrument for Chronic Hypersensitivity Pneumonitis.
Synthesis in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Inhalational exposures associated with risk of interstitial lung disease: a systematic review and meta-analysis.Thorax · 2025Pooled it
- Diagnosis and Treatment of Hypersensitivity Pneumonitis: S2k Guideline of the German Respiratory Society and the German Society for Allergology and Clinical Immunology.Respiration; international review of thoracic diseases · 2025Guideline
- Occupational causes of hypersensitivity pneumonitis: a systematic review and compendium.Occupational medicine (Oxford, England) · 2021Pooled it
- Cutoffs for serum mold-specific IgG levels for hypersensitivity pneumonitis: a diagnostic test accuracy study of 219 subjects.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2026Article
- Standard pulmonary function tests and respiratory oscillometry patterns in hypersensitivity pneumonitis and idiopathic pulmonary fibrosis.BMJ open respiratory research · 2025Article
- Analyzing Clinical Parameters and Bacterial Profiles to Uncover the COPD Exacerbations: A Focus on Intensive Care Unit Challenges.Medicina (Kaunas, Lithuania) · 2025Article
- Hypersensitivity pneumonitis associated with home mold exposure: A retrospective cohort analysis.PloS one · 2025Article
- Development and evaluation of a questionnaire to capture environmental and occupational inhalational exposures in adults with fibrotic interstitial lung disease.Respiratory research · 2024Article
- Does a Type of Inciting Antigen Correlate with the Presence of Lung Fibrosis in Patients with Hypersensitivity Pneumonitis?Journal of clinical medicine · 2024Article
- Effect of antigen removal in hypersensitivity pneumonitis.BMC pulmonary medicine · 2024Article
- Scoping review of exposure questionnaires and surveys in interstitial lung disease.BMJ open respiratory research · 2024Article
- Assessment of clinical relevance of antigen improves diagnostic accuracy of hypersensitivity pneumonitis.BMC pulmonary medicine · 2024Article
- Occupational hypersensitivity pneumonia.Tuberkuloz ve toraks · 2023Review
- Diagnosis, course and management of hypersensitivity pneumonitis.European respiratory review : an official journal of the European Respiratory Society · 2022Review
- Challenges in the Diagnosis and Management of Fibrotic Hypersensitivity Pneumonitis: A Practical Review of Current Approaches.Journal of clinical medicine · 2022Review
- Impact of number and type of identified antigen on transplant-free survival in hypersensitivity pneumonitis.PloS one · 2022Article
- Barriers to antigen detection and avoidance in chronic hypersensitivity pneumonitis in the United States.Respiratory research · 2021Article
- Review
- Performance of a diagnostic algorithm for fibrotic hypersensitivity pneumonitis. A case-control study.Respiratory research · 2021Article
- Exposure Assessment Tools for Hypersensitivity Pneumonitis. An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2020Article
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundChronic hypersensitivity pneumonitis (CHP) is an immune-mediated interstitial lung disease (ILD) caused by inhalational exposure to environmental antigens, resulting in parenchymal fibrosis. By definition, a diagnosis of CHP assumes a history of antigen exposure, but only half of all patients eventually diagnosed with CHP will have a causative antigen identified. Individual clinician variation in eliciting a history of antigen exposure may affect the frequency and confidence of CHP diagnosis.
methodsA list of potential causative exposures were derived from a systematic review of the literature. A Delphi method was applied to an international panel of ILD experts to obtain consensus regarding technique for the elicitation of exposure to antigens relevant to a diagnosis of CHP. The consensus threshold was set at 80% agreement, and median ≤ 2, interquartile range = 0 on a 5-point Likert scale (1, strongly agree; 2, tend to agree; 3, neither agree nor disagree; 4, disagree; 5, strongly disagree).
resultsIn two rounds, 36/40 experts participated. Experts agreed on 18 exposure items to ask every patient with suspected CHP. Themes included CHP inducing exposures, features that contribute to an exposure's relevance, and quantification of a relevant exposure. Based on the results from the literature review and Delphi process, a CHP exposure assessment instrument was derived. Using cognitive interviews, the instrument was revised by patients with ILD for readability and usability.
conclusionsThis Delphi survey provides items that ILD experts agree are important to ask in all patients presenting with suspected CHP and provides basis for a systematically derived CHP exposure assessment instrument. Clinical utility of this exposure assessment instrument may be affected by different local prevalence patterns of exposures. Ongoing research is required to clinically validate these items and consider their impact in more geographically diverse settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.