Clinical predictors of a diagnosis of idiopathic pulmonary fibrosis.
BACKGROUND
Idiopathic pulmonary fibrosis (IPF) and other idiopathic interstitial pneumonias (IIPs) have similar clinical and radiographic features, but their histopathology, response to therapy, and natural history differ. A surgical lung biopsy is often required to distinguish between these entities.


OBJECTIVE
We sought to determine if clinical variables could predict a histopathologic diagnosis of IPF in patients without honeycomb change on high-resolution computed tomography (HRCT).


METHODS
Data from 97 patients with biopsy-proven IPF and 38 patients with other IIPs were examined. Logistic regression models were built to identify the clinical variables that predict histopathologic diagnosis of IPF.


RESULTS
Increasing age and average total HRCT interstitial score on HRCT scan of the chest may predict a biopsy confirmation of IPF. Sex, pulmonary function, presence of desaturation, or distance walked during a 6-minute walk test did not help discriminate pulmonary fibrosis from other IIPs.


CONCLUSIONS
Clinical data may be used to predict a diagnosis of IPF over other IIPs. Validation of these data with a prospective study is needed.
Fell
Charlene D
CD
Division of Respiratory Medicine, University of Calgary, Calgary, AB, T1Y 6J4 Canada. cfell@ucalgary.ca
Martinez
Fernando J
FJ
Liu
Lyrica X
LX
Murray
Susan
S
Han
Meilan K
MK
Kazerooni
Ella A
EA
Gross
Barry H
BH
Myers
Jeffrey
J
Travis
William D
WD
Colby
Thomas V
TV
Toews
Galen B
GB
Flaherty
Kevin R
KR
D000367:Age Factors; D001706:Biopsy; D003937:Diagnosis, Differential; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000175:diagnosis; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000473:pathology; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods