title: Prediction of Anthracofibrosis Based on Clinico-Radiographic Findings.
abstract: OBJECTIVE
  Because anthracofibrosis (AF) is associated with tuberculosis (TB), detection of AF is clinically relevant in Korea, a TB endemic region. We thus sought to develop and validate a predictive model for AF using clinical radiographic data.
  
  
  METHODS
  Between January 1, 2008 and March 31, 2014, 3849 adult patients who underwent bronchoscopies were retrospectively included from an observational registry. We dichotomized patients based on the presence (n=167) or absence (n=242) of AF. After analyzing their clinico-radiographic characteristics, a logistic prediction model was developed. An area under the curve (AUC) was drawn using the weighted score in logistic regression model. To evaluate the degree of overfitting of the predictive model, a 5-fold cross-validation procedure was performed.
  
  
  RESULTS
  In multivariate logistic regression, clinical findings such as age >70 years, female gender, active TB, and computed tomography findings including atelectasis, stenosis, bronchial wall thickening, enlarged and calcified lymph nodes were significant diagnostic predictors for AF. The weighed score had an AUC of 0.939 [95% confidence interval (CI)=0.911-0.960], similar to the AUC obtained from internal validation (AUC=0.926, 95% CI=0.896-0.949).
  
  
  CONCLUSIONS
  The prediction model may be helpful for predicting AF based only on clinical and radiographic findings. However, further external validation is necessary.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Tae Yun
authors.initials: TY
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Heo
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Hee Soon
authors.initials: HS
authors.lastname: Chung
authors.affiliation: Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Kwang Nam
authors.initials: KN
authors.lastname: Jin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. kimdkmd@gmail.com.
authors.forename: Deog Kyeom
authors.initials: DK
authors.lastname: Kim
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001980:Bronchi / Q000000981:diagnostic imaging* / Q000473:pathology; D001999:Bronchoscopy; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D056910:Republic of Korea; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging
keywords: Anthracofibrosis; airway disease; bronchoscopy; computed tomography; tuberculosis