title: A diagnostic model for chronic hypersensitivity pneumonitis.
abstract: The objective of this study was to develop a diagnostic model that allows for a highly specific diagnosis of chronic hypersensitivity pneumonitis using clinical and radiological variables alone. Chronic hypersensitivity pneumonitis and other interstitial lung disease cases were retrospectively identified from a longitudinal database. High-resolution CT scans were blindly scored for radiographic features (eg, ground-glass opacity, mosaic perfusion) as well as the radiologist's diagnostic impression. Candidate models were developed then evaluated using clinical and radiographic variables and assessed by the cross-validated C-statistic. Forty-four chronic hypersensitivity pneumonitis and eighty other interstitial lung disease cases were identified. Two models were selected based on their statistical performance, clinical applicability and face validity. Key model variables included age, down feather and/or bird exposure, radiographic presence of ground-glass opacity and mosaic perfusion and moderate or high confidence in the radiographic impression of chronic hypersensitivity pneumonitis. Models were internally validated with good performance, and cut-off values were established that resulted in high specificity for a diagnosis of chronic hypersensitivity pneumonitis.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kerri A
authors.initials: KA
authors.lastname: Johannson
authors.affiliation: Department of Radiology, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Brett M
authors.initials: BM
authors.lastname: Elicker
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.affiliation: Montreal Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Assayag
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Kaïssa
authors.initials: K
authors.lastname: de Boer
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Golden
authors.affiliation: Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Kirk D
authors.initials: KD
authors.lastname: Jones
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Talmadge E
authors.initials: TE
authors.lastname: King
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Koth
authors.affiliation: University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Joyce S
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Ley
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Wolters
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Harold R
authors.initials: HR
authors.lastname: Collard
mesh_terms: D000328:Adult; D000368:Aged; D000542:Alveolitis, Extrinsic Allergic / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Clinical Epidemiology; Hypersensitivity pneumonitis; Interstitial Fibrosis