Identifying best composite prognosticators in fibrosing lung diseases

  • Research type

    Research Study

  • Full title

    Identifying the optimum composite indicators of prognosis in fibrosing lung diseases by analysing serial lung function tests, and baseline and serial visual and computer algorithmic CT assessment.

  • IRAS ID

    143743

  • Contact name

    Athol U Wells

  • Contact email

    RBHILD@rbht.nhs.uk

  • Sponsor organisation

    Royal Brompton And Harefield NHS Trust

  • Duration of Study in the UK

    5 years, 4 months, 29 days

  • Research summary

    The fibrotic interstitial lung diseases (ILD) are a group of chronic lung diseases that have a significant mortality, with one particular subtype - idiopathic interstitial pneumonia - displaying a 70% 5-year mortality. Identifying disease worsening at an early stage is desirable to reduce mortality and morbidity. Monitoring is performed by analysing computed tomography (CT) scans and lung function tests.

    While regarding CT, this is usually performed by visual analysis of scans by radiologists, a new development is that of computer assisted quantitative analysis of a CT scan which is thought to be free of variations between observers that occurs in visual CT scoring. To this end we aim to use new computer based technology based in the Mayo Clinic in Minnesota, USA to analyse previously visually scored CT images. Lastly, it is postulated but has not yet been shown that serial CT scans are more accurate than single studies in identifying disease progression.

    We aim, in a retrospective part of the study to look at a cohort of roughly 500 patients with specific ILD subtypes who have had a baseline CT scan and concurrent lung function tests. From this group we aim to identify those CT factors (determined by visual and computer scoring) and lung function parameters that were most closely predictive of mortality over a roughly 10 year period. With this information we aim to create a composite indicator score than is clinically applicable and allows simple prognostication of likelihood of disease progression.

    In a prospective part of the study, we will include consecutive patients presenting with any fibrotic ILD who have a clinically indicated CT scan and lung function tests within a defined period. Their CT scans will be analysed (again visually and with a computer algorithm) and we will test those composite indicators that were predictive of decline in our retrospective study.

  • REC name

    North West - Liverpool Central Research Ethics Committee

  • REC reference

    14/NW/0028

  • Date of REC Opinion

    23 Jan 2014

  • REC opinion

    Further Information Favourable Opinion