TY - JOUR
T1 - Smoking-related idiopathic interstitial pneumonia
AU - Flaherty, Kevin R.
AU - Fell, Charlene
AU - Aubry, Marie Christine
AU - Brown, Kevin
AU - Colby, Thomas
AU - Costabel, Ulrich
AU - Franks, Teri J.
AU - Gross, Barry H.
AU - Hansell, David M.
AU - Kazerooni, Ella
AU - Kim, Dong Soon
AU - King, Talmadge E.
AU - Kitachi, Masanori
AU - Lynch, David
AU - Myers, Jeff
AU - Nagai, Sonoko
AU - Nicholson, Andrew G.
AU - Poletti, Venerino
AU - Raghu, Ganesh
AU - Selman, Moises
AU - Toews, Galen
AU - Travis, William
AU - Wells, Athol U.
AU - Vassallo, Robert
AU - Martinez, Fernando J.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Cigarette smoking is a key factor in the development of numerous pulmonary diseases. An international group of clinicians, radiologists and pathologists evaluated patients with previously identified idiopathic interstitial pneumonia (IIP) to determine unique features of cigarette smoking. Phase 1 (derivation group) identified smoking-related features in patients with a history of smoking (n541). Phase 2 (validation group) determined if these features correctly predicted the smoking status of IIP patients (n5100) to participants blinded to smoking history. Finally, the investigators sought to determine if a new smoking-related interstitial lung disease phenotype could be defined. Phase 1 suggested that preserved forced vital capacity with disproportionately reduced diffusing capacity of the lung for carbon monoxide, and various radiographic and histopathological findings were smoking-related features. In phase 2, the kappa coefficient among clinicians was 0.16 (95% CI 0.11-0.21), among the pathologists 0.36 (95% CI 0.32-0.40) and among the radiologists 0.43 (95% CI 0.35-0.52) for smoking-related features. Eight of the 100 cases were felt to represent a potential smoking-related interstitial lung disease. Smoking-related features of interstitial lung disease were identified in a minority of smokers and were not specific for smoking. This study is limited by its retrospective design, the potential for recall bias in smoking history and lack of information on second-hand smoke exposure. Further research is needed to understand the relationship between smoking and interstitial lung disease.
AB - Cigarette smoking is a key factor in the development of numerous pulmonary diseases. An international group of clinicians, radiologists and pathologists evaluated patients with previously identified idiopathic interstitial pneumonia (IIP) to determine unique features of cigarette smoking. Phase 1 (derivation group) identified smoking-related features in patients with a history of smoking (n541). Phase 2 (validation group) determined if these features correctly predicted the smoking status of IIP patients (n5100) to participants blinded to smoking history. Finally, the investigators sought to determine if a new smoking-related interstitial lung disease phenotype could be defined. Phase 1 suggested that preserved forced vital capacity with disproportionately reduced diffusing capacity of the lung for carbon monoxide, and various radiographic and histopathological findings were smoking-related features. In phase 2, the kappa coefficient among clinicians was 0.16 (95% CI 0.11-0.21), among the pathologists 0.36 (95% CI 0.32-0.40) and among the radiologists 0.43 (95% CI 0.35-0.52) for smoking-related features. Eight of the 100 cases were felt to represent a potential smoking-related interstitial lung disease. Smoking-related features of interstitial lung disease were identified in a minority of smokers and were not specific for smoking. This study is limited by its retrospective design, the potential for recall bias in smoking history and lack of information on second-hand smoke exposure. Further research is needed to understand the relationship between smoking and interstitial lung disease.
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U2 - 10.1183/09031936.00166813
DO - 10.1183/09031936.00166813
M3 - Article
C2 - 25063244
AN - SCOPUS:84907333644
SN - 0903-1936
VL - 44
SP - 594
EP - 602
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 3
ER -