Evidence map›Paper›PMID 32030242›Full record

ArticleJournal of thoracic disease2019

Predictive factors of mortality in rheumatoid arthritis-associated interstitial lung disease analysed by modified HRCT classification of idiopathic pulmonary fibrosis according to the 2018 ATS/ERS/JRS/ALAT criteria.

Hideaki Yamakawa, Shintaro Sato, Emiri Tsumiyama, Tomotaka Nishizawa, Rie Kawabe, Tomohiro Oba, Teppei Kamikawa, Masanobu Horikoshi, Keiichi Akasaka, Masako Amano and 2 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 4 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Hideaki YamakawaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Shintaro SatoDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Emiri TsumiyamaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Tomotaka NishizawaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Rie KawabeDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Tomohiro ObaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Teppei KamikawaDepartment of Rheumatology, Saitama Red Cross Hospital, Saitama, Japan.
Masanobu HorikoshiDepartment of Rheumatology, Saitama Red Cross Hospital, Saitama, Japan.
Keiichi AkasakaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Masako AmanoDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Kazuyoshi KuwanoDepartment of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Tokyo, Japan.
Hidekazu MatsushimaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.
Saitama Red Cross Hospital · JPJikei University School of Medicine · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInterstitial lung disease (ILD) is associated with high morbidity and mortality in rheumatoid arthritis (RA). Although usual interstitial pneumonia (UIP) pattern was reported as a poor prognostic factor, in clinical practice, we often cannot classify high-resolution computed tomography (HRCT) patterns specifically as UIP or nonspecific interstitial pneumonia (NSIP). This study of RA-ILD aimed to elucidate prognosis by using our modified HRCT pattern classification according to the latest guideline on idiopathic pulmonary fibrosis (IPF).

methodsWe analysed the medical records of 96 consecutive patients diagnosed as having RA-ILD. The modified HRCT classifications were defined as definite UIP, probable UIP, indeterminate for UIP (i.e., early UIP or NSIP/UIP), NSIP, organizing pneumonia (OP), NSIP+OP, and unclassifiable. Predictors of prognosis were determined using Cox regression models.

resultsOur RA-ILD cohort included definite UIP (21%), probable UIP (20%), indeterminate for UIP (30%) including NSIP/UIP (27%), alternative diagnosis (29%) including NSIP (14%), and other patterns. Interrater agreement for HRCT pattern was good (κ=0.75). Multivariate analysis showed that older age, history of acute exacerbation, and radiological honeycombing were negative prognostic factors of mortality.

conclusionsNSIP/UIP pattern of indeterminate for UIP was the major pattern in RA-ILD. Although classifications of HRCT patterns were not related to survival, the presence of radiological honeycombing could be a useful predictor of poor prognosis, and acute exacerbation of ILD can seriously impact patient survival regardless of the presence of a UIP or indeterminate for UIP pattern. Our modified HRCT classification based on the latest IPF guideline might be useful to assess appropriate strategies of diagnosis in future RA-ILD studies, and radiological honeycombing could better predict poor prognosis rather than HRCT pattern.

Indexed as

Honeycombinginterstitial lung disease (ILD)prognosisradiological patternrheumatoid arthritis (RA)

Identifiers

PMID32030242
PMCPMC6987998
OpenAlexW2998539297

What OpenQuestion holds

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Registered trials

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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.