Detection of Interstitial Lung Disease in Rheumatoid Arthritis by Thoracic Ultrasound: A Diagnostic Test Accuracy Study
Authors' conclusion
Systematic screening for respiratory symptoms combined with TUS can reduce the diagnostic delay of ILD in RA.
Study context
- Population
- Individuals with rheumatoid arthritis (RA) and a positive screening for respiratory symptoms (dyspnea, cough, recurrent pneumonia, prior severe pneumonia, or chest x-ray indicating interstitial abnormalities), rheumatologic outpatient clinics, Region of Southern Denmark; excluded if high-resolution computed tomography (HRCT) <12 months ago or interstitial lung disease (ILD) already diagnosed77 received HRCT <30 days after thoracic ultrasound (TUS)
- Participants
- 80 individuals
- Comparison
- TUS vs HRCT with multidisciplinary team discussion
- Outcome
- TUS's sensitivity, specificity, and positive predictive value and negative predictive value for ILD (reference standard HRCT with multidisciplinary team discussion)
Methodological detailsprospective, consecutive inclusion, blinded TUS expert, reference standard: HRCT assessed by ILD-specialized thoracic radiologist followed by multidisciplinary team discussion
- Prospective
- Consecutive inclusion
- Blinded TUS expert
- Reference standard: HRCT assessed by ILD-specialized thoracic radiologist followed by multidisciplinary team discussion
Performance
As reported in the abstract
Diagnostic accuracy of TUS for ILD
| Test or model | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| TUS | 82.6% (95% CI 61.2%-95.0%) | 51.9% (95% CI 37.8%-65.7%) | 42.2% (95% CI 27.7%-57.8%) | 87.5% (95% CI 71.0%-96.5%) |
TUS
Sensitivity82.6% (95% CI 61.2%-95.0%)
Specificity51.9% (95% CI 37.8%-65.7%)
PPV42.2% (95% CI 27.7%-57.8%)
NPV87.5% (95% CI 71.0%-96.5%)
Further findings
- ILD diagnosed (prevalence) — HRCT
- 30%
- ILD diagnosed (prevalence): of 77 participants receiving HRCT
Original publication
Detection of Interstitial Lung Disease in Rheumatoid Arthritis by Thoracic Ultrasound: A Diagnostic Test Accuracy Study. Arthritis Care Res (Hoboken). Published 23 June 2024. doi:10.
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