دورية أكاديمية
A multidimensional classifier to support lung transplant referral in patients with pulmonary fibrosis.
| العنوان: | A multidimensional classifier to support lung transplant referral in patients with pulmonary fibrosis. |
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| المؤلفون: | Pugashetti JV; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan., Kim JS; Division of Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, Virginia., Combs MP; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan., Ma SF; Division of Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, Virginia., Adegunsoye A; Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, Illinois., Linderholm AL; Department of Internal Medicine, University of California Davis, Davis, California., Strek ME; Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, Illinois., Chen CH; Department of Internal Medicine, University of California Davis, Davis, California., Dilling DF; Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois., Whelan TPM; Division of Pulmonary and Critical Care, Medical University of South Carolina, Charleston, South Carolina; Pulmonary Fibrosis Foundation, Chicago, Illinois., Flaherty KR; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan; Pulmonary Fibrosis Foundation, Chicago, Illinois., Martinez FJ; Division of Pulmonary and Critical Care, Weill Cornell Medical Center, New York, New York., Noth I; Division of Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, Virginia., Oldham JM; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan. Electronic address: oldhamj@med.umich.edu. |
| المصدر: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2024 Jul; Vol. 43 (7), pp. 1174-1182. Date of Electronic Publication: 2024 Mar 29. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 9102703 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-3117 (Electronic) Linking ISSN: 10532498 NLM ISO Abbreviation: J Heart Lung Transplant Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1999- : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby-Year Book, Inc., c1991- |
| مواضيع طبية MeSH: | Lung Transplantation* , Referral and Consultation* , Idiopathic Pulmonary Fibrosis*/surgery , Idiopathic Pulmonary Fibrosis*/classification , Idiopathic Pulmonary Fibrosis*/diagnosis , Idiopathic Pulmonary Fibrosis*/blood, Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Proteomics |
| مستخلص: | Background: Lung transplantation remains the sole curative option for patients with idiopathic pulmonary fibrosis (IPF), but donor organs remain scarce, and many eligible patients die before transplant. Tools to optimize the timing of transplant referrals are urgently needed. Methods: Least absolute shrinkage and selection operator was applied to clinical and proteomic data generated as part of a prospective cohort study of interstitial lung disease (ILD) to derive clinical, proteomic, and multidimensional logit models of near-term death or lung transplant within 18 months of blood draw. Model-fitted values were dichotomized at the point of maximal sensitivity and specificity, and decision curve analysis was used to select the best-performing classifier. We then applied this classifier to independent IPF and non-IPF ILD cohorts to determine test performance characteristics. Cohorts were restricted to patients aged ≤72 years with body mass index 18 to 32 to increase the likelihood of transplant eligibility. Results: IPF derivation, IPF validation, and non-IPF ILD validation cohorts consisted of 314, 105, and 295 patients, respectively. A multidimensional model comprising 2 clinical variables and 20 proteins outperformed stand-alone clinical and proteomic models. Following dichotomization, the multidimensional classifier predicted near-term outcome with 70% sensitivity and 92% specificity in the IPF validation cohort and 70% sensitivity and 80% specificity in the non-IPF ILD validation cohort. Conclusions: A multidimensional classifier of near-term outcomes accurately discriminated this end-point with good test performance across independent IPF and non-IPF ILD cohorts. These findings support refinement and prospective validation of this classifier in transplant-eligible individuals. (Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: biomarker; idiopathic pulmonary fibrosis; interstitial lung disease; proteomics; survival |
| تواريخ الأحداث: | Date Created: 20240331 Date Completed: 20240601 Latest Revision: 20240601 |
| رمز التحديث: | 20240602 |
| DOI: | 10.1016/j.healun.2024.03.018 |
| PMID: | 38556070 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1557-3117 |
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| DOI: | 10.1016/j.healun.2024.03.018 |