Evidence map›Paper›PMID 41680788›Full record

ArticleRespiratory research2026

Multimodal phenotyping of ARDS: design and preliminary insights from the prospective BIOWARE cohort for precision critical management.

Ziqi Tan, Weida Liu, Song Zhang, Mei Yang, Chaofu Yue, Xian Huang, Keyi Zhao, Zuxi Niu, Yongjie Wang, Xin Yu and 12 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Ziqi Tan *Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Weida Liu *Peking Union Medical College Hospital, State Key Laboratory for Complex Severe and Rare Diseases, Institute of Clinical Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Song ZhangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Mei YangDepartment of Critical Care Medicine, Qujing Central Hospital, Qujing, China.
Chaofu YueDepartment of Critical Care Medicine, Qujing Central Hospital, Qujing, China.
Xian HuangDepartment of Critical Care Medicine, Qujing Central Hospital, Qujing, China.
Keyi ZhaoDepartment of Critical Care Medicine, Qujing Central Hospital, Qujing, China.
Zuxi NiuDepartment of Critical Care Medicine, Heze Municipal Hospital, Heze, China.
Yongjie WangDepartment of Critical Care Medicine, Jilin Provincial People's Hospital, Changchun, China.
Xin YuDepartment of Critical Care Medicine, Jilin Provincial People's Hospital, Changchun, China.
Xiangyou YuDepartment of Critical Care Medicine, The first Affiliated Hospital of XinJiang Medical University, Urumqi, China.
Chunbo YangDepartment of Critical Care Medicine, The first Affiliated Hospital of XinJiang Medical University, Urumqi, China.
Siqing MaDepartment of Critical Care Medicine, Qinghai Provincial People's Hospital, Xining, China.
Qiang SunDepartment of Critical Care Medicine, Jining Medical University Affiliated Hospital, Jining, China.
Zhiqiang ZhuEmergency Intensive Care Unit, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Min YangThe Second Department of Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Fang WangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Shulin ZhangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Longxiang SuDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China. sulongxiang@gmail.com.
Yingying YangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China. pumchyyy@163.com.
Qianlin WangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China. wangql_1012@163.com.
Yun LongDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China. icu_longyun@126.com.

Funding

National High-Level Hospital Clinical Research Funding 2025-PUMCH-C-036National Natural Science Foundation of China 82572523
6 · The paper itself

Abstract

backgroundAcute respiratory distress syndrome (ARDS) is a highly heterogeneous syndrome with substantial mortality, for which existing subphenotyping strategies based on single-modal data have limited ability to guide targeted therapies. A comprehensive, multimodal framework is urgently needed to decipher its complexity and advance precision care.

methodsThe BIOWARE study is a prospective, multicenter cohort aiming to enroll 2,000 ARDS patients across nine Chinese centers. The protocol integrates longitudinal data from clinical assessments, ventilator waveforms, advanced imaging (CT, EIT, lung ultrasound), and biospecimen analyses.

findingsAs of August 2025, 169 patients have been enrolled (median age 62 years, 74% male). Core clinical and imaging data were successfully acquired across all centers, confirming the feasibility of the multimodal collection protocol. While baseline biospecimen collection was complete (100% for plasma and BALF at Day 1), follow-up sampling decreased at later timepoints (Day 7 BALF: n = 24). Some specialized parameters (e.g., P0.1) showed higher missing rates due to clinical constraints, reflecting real-world implementation challenges.

interpretationThe BIOWARE cohort provides a multidimensional framework that captures dynamic interactions among physiology, pulmonary structural changes, and host response, enabling identification of ARDS endotypes grounded in biological mechanisms. This integrative strategy represents a paradigm shift from syndrome-based classification toward mechanism-driven precision care, establishing a transformative platform for targeted therapeutic development.

Indexed as

Critical CarePhenotypePrecision MedicineRespiratory Distress SyndromeAgedCohort StudiesFemaleHumansMaleMiddle AgedProspective StudiesAcute respiratory distress syndromeCohort designMultimodal dataPrecision MedicineSubphenotypes

Identifiers

PMID41680788
PMCPMC13045106

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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.