| 1. Irwin RS, French CL, Chang AB, Altman KW, Panel* CEC. Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest 2018;153:196-209. |
Review/Other-Dx |
11 studies |
To perform a systematic review using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? |
With respect to acute cough (< 3 weeks), only three studies met our criteria for quality assessment, and all had a high risk of bias. As predicted by the 2006 CHEST Cough Guidelines, the most common causes were respiratory infections, most likely of viral cause, followed by exacerbations of underlying diseases such as asthma and COPD and pneumonia. The subjects resided on three continents: North America, Europe, and Asia. With respect to subacute cough (duration, 3-8 weeks), only two studies met our criteria for quality assessment, and both had a high risk of bias. As predicted by the 2006 guidelines, the most common causes were postinfectious cough and exacerbation of underlying diseases such as asthma, COPD, and upper airway cough syndrome (UACS). The subjects resided in countries in Asia. With respect to chronic cough (> 8 weeks), 11 studies met our criteria for quality assessment, and all had a high risk of bias. As predicted by the 2006 guidelines, the most common causes were UACS from rhinosinus conditions, asthma, gastroesophageal reflux disease, nonasthmatic eosinophilic bronchitis, combinations of these four conditions, and, less commonly, a variety of miscellaneous conditions and atopic cough in Asian countries. The subjects resided on four continents: North America, South America, Europe, and Asia. |
4 |
| 2. Kuzniar TJ, Morgenthaler TI, Afessa B, Lim KG. Chronic cough from the patient's perspective. Mayo Clin Proc. 82(1):56-60, 2007 Jan. |
Observational-Dx |
146 patients |
To identify the factors that patients consider most concerning about their cough. |
Of the 146 consecutive patients referred for evaluation of chronic cough, 136 were eligible for inclusion in the study. These patients cited feelings of frustration, irritability, or anger (43%), frequent physician visits and testing (41%), and sleep disturbances (38%) as the most prevalent major problems. The responses to individual items on the questionnaire were not related to patients' age, sex, and cough duration. Anxiety about underlying serious illness continued to be a concern for most patients. |
2 |
| 3. Truba O, Rybka A, Klimowicz K, et al. Is a normal chest radiograph sufficient to exclude pulmonary abnormalities potentially associated with chronic cough?. Advances in Respiratory Medicine. 86(3), 2018. |
Observational-Dx |
59 patients |
To assess whether a plain CXR is a sufficient tool to exclude relevant pulmonary causes of chronic cough. |
The study group consisted of 59 adult patients with chronic cough, normal CXR and CT scan performed to diagnose the cause of chronic cough. In 21 patients (21/59, 36%), chest CT revealed abnormalities that were classified as relevant to chronic cough. The most frequent were: bronchiectasis (7/59, 11.9%), bronchial wall thickening (6/59, 10.2%) and mediastinal lymphadenopathy (5/59, 8.5%). The NPV of a CXR in diagnosing the causes of chronic cough was 64%. |
2 |
| 4. Kwak HJ, Moon JY, Choi YW, et al. High prevalence of bronchiectasis in adults: analysis of CT findings in a health screening program. Tohoku J Exp Med. 222(4):237-42, 2010 Dec. |
Observational-Dx |
5,727 patients |
To estimate the prevalence and risk factors of bronchiectasis in adults. |
From January to December 2008, 1,409 (24.6%) of 5,727 participants in the screening program of a health promotion center at a university hospital underwent chest CT scans based on the subject's decision. Bronchiectasis was diagnosed, if there was abnormal bronchial dilatation in any area of both lungs on chest CT. Respiratory symptoms, smoking status, and past medical history were also analyzed to define clinical characteristics and risk factors of bronchiectasis. Of 1,409 patients (aged 23-86 years), who were screened for respiratory diseases using chest CT for one year in a health promotion center, 129 patients (9.1%) were diagnosed with bronchiectasis. The prevalence of bronchiectasis was higher in females than in males (11.5% vs. 7.9%, p = 0.022) and increased with age. Respiratory symptoms were reported in 53.7% of subjects. Previous history of tuberculosis (TB) (OR 4.61, 95% CI 2.39-8.88, p = 0.001) and age (OR 2.49, 95% CI 1.56-3.98, p = 0.001) were significantly associated with bronchiectasis. This retrospective analysis of chest CT findings in health screening examinees revealed a very high prevalence of bronchiectasis in adults. Previous TB infection is one of the major causes of bronchiectasis. |
2 |
| 5. Martin MJ, Harrison TW. Causes of chronic productive cough: An approach to management. [Review]. Respir Med. 109(9):1105-13, 2015 Sep. |
Review/Other-Dx |
N/A |
To summarise the epidemiology, clinical features, pathophysiology and treatment of a number of conditions which are often associated with chronic productive cough to aid decision making when encountering a patient with this often distressing symptom. |
No results stated in the abstract. |
4 |
| 6. Ooi GC, Khong PL, Chan-Yeung M, et al. High-resolution CT quantification of bronchiectasis: clinical and functional correlation. Radiology. 225(3):663-72, 2002 Dec. |
Observational-Dx |
60 patients |
To evaluate clinical relevance of high-resolution computed tomographic (CT) findings in patients with bronchiectasis by using a quantitative high-resolution CT protocol to assess extent of bronchiectasis, severity of bronchial wall thickening, and presence of small-airway abnormalities and mosaic pattern. |
Exacerbation frequency was associated with bronchial wall thickening (r = 0.32, P =.03); 24-hour sputum volume with bronchial wall thickening and small-airway abnormalities (r = 0.30 and 0.39, respectively; P <.05); and forced expiratory volume in 1 second (FEV(1)), ratio of FEV(1) to forced vital capacity (FVC), and midexpiratory phase of forced expiratory flow (FEF(25%-75%)) (r = -0.33, -0.29, and -0.32, respectively; P <.05). Extent of bronchiectasis, bronchial wall thickening, and mosaic attenuation, respectively, were related to FEV(1) (r = -0.43 to -0.60, P <.001), FEF(25%-75%) (r = -0.38 to -0.57, P <.001), FVC (r = -0.36 to -0.46, P <.01), and FEV(1)/FVC ratio (r = -0.31 to -0.49, P <.01). After multiple regression analysis, bronchial wall thickening remained a significant determinant of airflow obstruction, whereas small-airway abnormalities remained associated with 24-hour sputum volume. Women had milder disease than men but showed more high-resolution CT functional correlations. |
2 |
| 7. Kastelik JA, Aziz I, Ojoo JC, Thompson RH, Redington AE, Morice AH. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir J 2005;25:235-43. |
Observational-Dx |
131 patients |
To discuss the investigation and management of chronic cough using a probability-based algorithm. |
In total, 148 patients were referred for assessment. However, eight failed to attend a follow-up appointment, two died due to unrelated causes, two moved from the area, and five declined further investigation or treatment. Therefore, full information was available for 131 patients, of whom 116 were referred by a primary care physician and 15 by a hospital specialist. |
2 |
| 8. McGarvey L, Gibson PG. What Is Chronic Cough? Terminology. J Allergy Clin Immunol Pract. 7(6):1711-1714, 2019 Jul - Aug. |
Review/Other-Dx |
N/A |
To discuss the terminology of Chronic Cough. |
No results stated in the abstract. |
4 |
| 9. McCallion P, De Soyza A. Cough and bronchiectasis. [Review]. Pulmonary Pharmacology & Therapeutics. 47:77-83, 2017 Dec. |
Review/Other-Dx |
N/A |
To review current concepts in bronchiectasis and focusses on the complex aspects of chronic cough in this setting. |
No results stated in the abstract. |
4 |
| 10. Pacheco A, de Diego A, Domingo C, et al. Chronic Cough. Archivos de Bronconeumologia. 51(11):579-89, 2015 Nov. |
Review/Other-Dx |
N/A |
To discuss the diagnostic an dtherapeutic effect of chronic cough. |
No results stated in the abstract. |
4 |
| 11. Song WJ, Chang YS, Morice AH. Changing the paradigm for cough: does 'cough hypersensitivity' aid our understanding?. [Review]. Asia Pac Allergy. 4(1):3-13, 2014 Jan. |
Review/Other-Dx |
N/A |
To discuss what underlines Chronic cough. |
No results stated in the abstract. |
4 |
| 12. Tan BK, Chandra RK, Conley DB, Tudor RS, Kern RC. A randomized trial examining the effect of pretreatment point-of-care computed tomography imaging on the management of patients with chronic rhinosinusitis symptoms. Int Forum Allergy Rhinol. 1(3):229-34, 2011 May-Jun. |
Observational-Dx |
40 patients |
To prospectively evaluate 2 algorithms for the initial management of patients with symptoms of CRS who manifest a normal nasal endoscopic examination. |
The 2 groups were demographically and symptomatically similar with regard to 2003 Task Force major criteria. Otolaryngology follow-up was recommended in 11 of 20 pre-CT patients, all of whom (100%) returned. In contrast, only 10 of 20 EMT patients (50%) followed up as instructed (p < 0.05). Radiographic confirmation of CRS was found in 8 of 20 pre-CT patients, and only 2 of 9 patients after EMT (p = 0.61). EMT patients received more antibiotic prescriptions (relative ratio [RR], 2.50; 95% CI, 1.46-4.27), while pre-CT patients received more CT scans (RR, 2.22; 95% CI, 1.37-3.61). Overall prescriptions costs were similar to the EMT group ($253 vs $218; p = 0.37) and the overall number of otolaryngology visits was similar. |
2 |
| 13. Michaudet C, Malaty J. Chronic Cough: Evaluation and Management. [Review]. Am Fam Physician. 96(9):575-580, 2017 Nov 01. |
Review/Other-Dx |
N/A |
To discuss the evaluation and Management of Chronic Cough. |
No results sated in the abstract. |
4 |
| 14. Ando A, Smallwood D, McMahon M, Irving L, Mazzone SB, Farrell MJ. Neural correlates of cough hypersensitivity in humans: evidence for central sensitisation and dysfunctional inhibitory control. Thorax. 71(4):323-9, 2016 Apr. |
Observational-Dx |
16 patients |
To discuss the use of functional brain imaging to compare central neural responses to airway stimulation using inhaled capsaicin in healthy people and patients with cough hypersensitivity. |
Hypersensitivity in response to inhaled capsaicin coincided with elevated neural activity in the midbrain in a region encompassing the nucleus cuneiformis (left: p<0.001; right: p<0.001) and periaqueductal gray (p=0.008) in comparison to normal sensitivity in controls. The enhanced activity noted in the midbrain is similar to that occurring in patients with chronic pain, thus providing empirical evidence to support the notion that cough and pain share neurobiological similarities. Furthermore, patients with cough hypersensitivity displayed difficulty controlling their cough, which manifested as a failure to suppress cough during capsaicin challenge (ie, reduced cough frequency) in controls compared with patients with cough hypersensitivity (p=0.046). Cough suppression was associated with reduced activity in a forebrain network that included the dorsomedial prefrontal and anterior mid-cingulate cortices. Additionally, cough frequency was correlated with activity in the right inferior frontal gyrus (R(2)=0.6, p<0.001) and right anterior insula (R(2)=0.6, p<0.001), regions previously implicated in voluntary cough suppression. |
2 |
| 15. Tran BB, Ditto AM. Cough: A Practical and Multifaceted Approach to Diagnosis and Management. [Review]. Med Clin North Am. 104(1):45-59, 2020 Jan. |
Review/Other-Dx |
N/A |
To provide a practical approach to treatment and management of cough, emphasizing causes and potentiators. |
No results stated in the abstract. |
4 |
| 16. Turner RD, Bothamley GH. Chronic cough and a normal chest X-ray - a simple systematic approach to exclude common causes before referral to secondary care: a retrospective cohort study. NPJ Primary Care Respiratory Medicine. 26:15081, 2016 Mar 03. |
Review/Other-Dx |
404 patients |
To assess the management of chronic cough in primary care before referral to a cough clinic, and to assess the outcome of managing chronic cough with an approach of simple investigation and empirical treatment trials. |
In total, 404 patients were referred with isolated chronic cough . Clinical records were available for all of them. More than 95% were seen by one clinician (RDT). The median (interquartile range (IQR)) age was 52 years (40–64), and 252 (62.4%) were female (P=0.001 for an expected equal sex ratio). Diagnoses were not made for 138 patients (34.2%), mainly because of ongoing assessment at the time of the study and loss to follow-up (Figure 1). In those who completed follow-up, the median (IQR) number of visits was 2 (2–3). Forty-five of the 67 patients (67%) who failed to attend a scheduled follow-up appointment attended the clinic only once. The previous clinic intervention in 20 of these 67 had been to prescribe a proton pump inhibitor (PPI), and in 25 to trial inhaled or oral corticosteroids. There were no differences in the duration of cough, cough severity or cough-related quality of life at the first clinic visit in all those who were lost to follow-up from those who completed their intended management (median (IQR) duration, 6 (3–12) vs 6 (3–18) months, P=0.98; Leicester Cough Questionnaire (LCQ) score, 10.2 (8.7–13.1) vs 9.4 (7.9–11.8), P=0.18; visual analogue scale (VAS) score, 63 (45–87) vs 72 (54–90), P=0.18, respectively). |
4 |
| 17. Ojoo JC, Everett CF, Mulrennan SA, Faruqi S, Kastelik JA, Morice AH. Management of patients with chronic cough using a clinical protocol: a prospective observational study. Cough 2013;9:2. |
Observational-Dx |
112 patients |
To determine whether patients with chronic cough can be successfully managed using a clinical algorithm. |
81 (72%) were managed in the clinical arm. Of these 74 (66%) were discharged following response to therapy. 31 (28%) patients were converted to the investigative arm after failure of diagnosis in the clinical protocol. The commonest causes of cough were gastroesophageal reflux, asthma and chronic rhinitis. 51 (45.5%) patients responded to therapy based on diagnosis at initial assessment while a further 23 (20.5%) patients responded to sequential clinical trials for the commonest causes of cough. Cough severity score improved by a mean of 3.6 points on a numeric response score (from 0-10, p < 0.0001). |
2 |
| 18. Touw HR, Parlevliet KL, Beerepoot M, et al. Lung ultrasound compared with chest X-ray in diagnosing postoperative pulmonary complications following cardiothoracic surgery: a prospective observational study. Anaesthesia. 73(8):946-954, 2018 Aug. |
Observational-Dx |
177 patients |
To discuss the treatment of adult patients who had undergone cardiothoracic surgery. |
We recruited a total of 177 patients in whom both lung ultrasound and chest X-ray imaging were performed. Lung ultrasound identified 159 (90%) postoperative pulmonary complications on the day of admission compared with 107 (61%) identified with chest X-ray (p < 0.001). Lung ultrasound identified 11 out of 17 patients (65%) and chest X-ray 7 out of 17 patients (41%) with clinically-relevant postoperative pulmonary complications (p < 0.001). The clinically-relevant postoperative pulmonary complications were detected earlier using lung ultrasound compared with chest X-ray (p = 0.024). Overall inter-observer agreement for lung ultrasound was excellent (? = 0.907, p < 0.001). Following cardiothoracic surgery, lung ultrasound detected more postoperative pulmonary complications and clinically-relevant postoperative pulmonary complications than chest X-ray, and at an earlier time-point. Our results suggest lung ultrasound may be used as the primary imaging technique to search for postoperative pulmonary complications after cardiothoracic surgery, and will enhance bedside decision making. |
2 |
| 19. Tasci O, Hatipoglu ON, Cagli B, Ermis V. Sonography of the chest using linear-array versus sector transducers: Correlation with auscultation, chest radiography, and computed tomography. J Clin Ultrasound. 44(6):383-9, 2016 Jul 08. |
Observational-Dx |
55 patients |
To compare the efficacies of two sonographic (US) probes, a high-frequency linear-array probe and a lower-frequency phased-array sector probe in the diagnosis of basic thoracic pathologies. |
he linear-array probe had the highest performance in the identification of pneumothorax (83% sensitivity, 100% specificity, and 99% diagnostic accuracy) and pleural effusion (100% sensitivity, 97% specificity, and 98% diagnostic accuracy); the sector probe had the highest performance in the identification of consolidation (89% sensitivity, 100% specificity, and 95% diagnostic accuracy) and interstitial syndrome (94% sensitivity, 93% specificity, and 94% diagnostic accuracy). For all pathologies, the performance of US was superior to those of CXR and auscultation. |
2 |
| 20. Dogan C, Comert SS, Caglayan B, et al. A New Modality for the Diagnosis of Bleomycin-induced Toxicity: Ultrasonography. Arch Bronconeumol. 54(12):619-624, 2018 12. |
Observational-Dx |
30 patients |
To evaluate the role of ultrasonography (USG) in the diagnosis of bleomycin-induced pulmonary toxicity (BT). |
The study included a total of 30 patients. Nine patients were diagnosed as having BT according to their clinical and radiologic findings and PFT-DLCO measurements. The mean number of CTA images was 68.7±22 in patients with BT vs 28.2±9.3 in those without BT (P<.001). The difference in CTA images between the patients with and without ground glass density was statistically significant (28.3±9.5 and 64.6±24.5, respectively, P<.001). In patients with BT, there was a negative correlation between the number of CTAs and DLCO% and FVC% values (P=.004; P=.016). USG had a sensitivity of 100%, and a specificity of 95% diagnosing BT in selected patients. |
2 |
| 21. Buda N, Piskunowicz M, Porzezinska M, Kosiak W, Zdrojewski Z. Lung Ultrasonography in the Evaluation of Interstitial Lung Disease in Systemic Connective Tissue Diseases: Criteria and Severity of Pulmonary Fibrosis - Analysis of 52 Patients. Ultraschall Med. 37(4):379-85, 2016 Aug. |
Observational-Dx |
112 patients |
To describe the criteria for pulmonary fibrosis and the degree of the severity of the fibrosis during the course of interstitial lung disease through the TLU (transthoracic lung ultrasound). |
As a consequence of the statistical analysis, we defined our own criteria for pulmonary fibrosis in TLU: irregularity of the pleura line, tightening of the pleura line, the fragmentary nature of the pleura line, blurring of the pleura line, thickening of the pleura line, artifacts of line B = 3 and = 4, artifacts of Am line and subpleural consolidations < 5 mm. As a result of the conducted research, a scale of severity of pulmonary fibrosis in TLU was devised (UFI - Ultrasound Fibrosis Index), enabling a division to be made into mild, moderate and severe cases. |
4 |
| 22. Mohammadi A, Oshnoei S, Ghasemi-rad M. Comparison of a new, modified lung ultrasonography technique with high-resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma. Med. ultrasonography. 16(1):27-31, 2014 Mar. |
Observational-Dx |
70 patients |
To investigate the utility of modified trans-thoracic ultrasound (TTUS) scoring system according to the comet tail sign (B-line artifacts) and to compare it with high-resolution computed tomography (HRCT) findings in patients with SSc and pulmonary involvement |
A significantly positive correlation between TTUS and the severity of pulmonary involvement (Spearman's correlation coefficient= 0.695, P < 0.001), (LR=74.36, P<0.001) was found. When compared with HRCT as the gold standard method, the sensitivity, specificity, positive and negative predictive value of TTUS was 73.58%, 88.23%, 95.12% and 51.72% respectively. Kappa values for the intra-observer modified TTUS assessment was 0.838. |
2 |
| 23. Tardella M, Di Carlo M, Carotti M, Filippucci E, Grassi W, Salaffi F. Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis: Cut-off point definition for the presence of significant pulmonary fibrosis. Medicine (Baltimore). 97(18):e0566, 2018 May. |
Observational-Dx |
40 patients |
To establish the cut-off point of ultrasound (US) B-lines number for detecting the presence of significant interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) (SSc-ILD) in relation to high-resolution computed tomography (HRCT) findings |
Forty patients completed the study. The US B-lines number and the Warrick score confirmed excellent correlation (Spearman rho: 0.958, P?=?.0001). The ROC curve analysis revealed that the presence of 10 US B-lines is the cut-off point with the greatest positive likelihood ratio (12.52) for the presence of significant SSc-ILD.The detection of 10 B-lines is highly predictive for the HRCT presence of significant SSc-ILD. In SSc patients, the LUS assessment as first imaging tool may represent an effective model to improve the correct timing of chest HRCT. |
2 |
| 24. Moazedi-Fuerst FC, Kielhauser S, Brickmann K, et al. Sonographic assessment of interstitial lung disease in patients with rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus. Clin Exp Rheumatol. 33(4 Suppl 91):S87-91, 2015 Jul-Aug. |
Observational-Dx |
45 patients |
To determine the diagnostic value of lung ultrasound in the detection of interstitial pulmonary fibrosis in patients with a rheumatic disease. |
Twenty-eight percent of the RA cohort, 64% of the SSc patients and four out of 6 SLE patients showed ILD on HRCT. Pathological ultrasound patterns were significant more frequent in the ILD group than in the non-ILD group (comet tail artifacts/B-pattern: 100% vs. 12%, p<0.001; subpleural nodes: 55 % vs. 17%, p=0.006; thickenings of the pleural line: 95% vs. 12.5%, p<0.001). Subpleural nodes were present in 100% of the RA patients vs. 22% the SSc patients (p=0.003) and 50% of the SLE patients (p=0.049) with ILD. An irregular pleural line>3 mm was documented in 100% of SSC and SLE patients with ILD, vs. 86% of ILD patients suffering from RA (p=ns). |
2 |
| 25. National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 365(5):395-409, 2011 Aug 04. |
Observational-Dx |
53,454 persons |
To determine whether screening with low-dose computed tomography (CT) could reduce mortality from lung cancer. |
The rate of adherence to screening was more than 90%. The rate of positive screening tests was 24.2% with low-dose CT and 6.9% with radiography over all three rounds. A total of 96.4% of the positive screening results in the low-dose CT group and 94.5% in the radiography group were false positive results. The incidence of lung cancer was 645 cases per 100,000 person-years (1060 cancers) in the low-dose CT group, as compared with 572 cases per 100,000 person-years (941 cancers) in the radiography group (rate ratio, 1.13; 95% confidence interval [CI], 1.03 to 1.23). There were 247 deaths from lung cancer per 100,000 person-years in the low-dose CT group and 309 deaths per 100,000 person-years in the radiography group, representing a relative reduction in mortality from lung cancer with low-dose CT screening of 20.0% (95% CI, 6.8 to 26.7; P=0.004). The rate of death from any cause was reduced in the low-dose CT group, as compared with the radiography group, by 6.7% (95% CI, 1.2 to 13.6; P=0.02). |
3 |
| 26. Park JE, Kim Y, Lee SW, Shim SS, Lee JK, Lee JH. The usefulness of low-dose CT scan in elderly patients with suspected acute lower respiratory infection in the emergency room. Br J Radiol. 89(1060):20150654, 2016. |
Observational-Dx |
160 patients |
To evaluate the usefulness of low-dose CT (LDCT) for the diagnosis of acute lower respiratory infection (ALRI) in elderly patients in the emergency room (ER). |
49 patients showed negative CR, in whom the main CT patterns were diffuse bronchial wall thickening (n = 23), ground-glass opacity (n = 6), mixed centrilobular nodules and ground-glass opacity (n = 3), small consolidation (n = 8) or consolidation in the dependent lung (n = 9), while the other 111 patients with the main CT pattern of consolidation demonstrated pulmonary abnormality on CR. Pulmonary oedema (12.5%) and pleural effusion (23.1%) were associated. The rate of hospitalization, care in the intensive care unit, mortality and comorbidity were significantly higher in the CR(+)LDCT(+) group (88.3%, 36.1%, 18.2% and 59.5%) than in the CR(-)LDCT(+) group (55.1%, 8.2%, 2.0% and 38.8%; p = 0.05). |
2 |
| 27. Christe A, Charimo-Torrente J, Roychoudhury K, Vock P, Roos JE. Accuracy of low-dose computed tomography (CT) for detecting and characterizing the most common CT-patterns of pulmonary disease. Eur J Radiol. 82(3):e142-50, 2013 Mar. |
Observational-Dx |
60 patients |
To assess the ability of low-dose CT to detect and characterize the most common CT patterns of pulmonary disease. |
The lung segments (1080) showed 813 nodules, 596 ground-glass opacities, 74 airspace and 575 interstitial diseases and 64 normal segments. In particular, air-space disease and nodules were unaffected by the increase in noise. However, the sensitivity to detect ground-glass opacities, ground-glass nodules and interstitial opacities decreased significantly, from 89% to 77%, 86% to 68% and 91% to 71%, respectively (all p-values <0.00001). Using iterative reconstruction instead of the applied filtered back projection sensitivity for ground-glass nodules rose to the sensitivity of standard-dose CT in an additional phantom study. |
2 |
| 28. Schaal M, Severac F, Labani A, Jeung MY, Roy C, Ohana M. Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting. PLoS ONE. 11(12):e0168979, 2016. |
Observational-Dx |
55 patients |
To evaluate the diagnostic performance of Ultra-Low-Dose Chest CT (ULD CT) for the detection of any asbestos-related lesions (primary endpoint) and specific asbestos-related abnormalities, i.e. non-calcified and calcified pleural plaques, diffuse pleural thickening, asbestosis and significant lung nodules (secondary endpoints). |
Radiation dose was 17.9±1.2mGy.cm (0.25mSv) for the ULD-CT versus 288.8 ±151mGy. cm (4mSv); p <2.2e-16. Prevalence of abnormalities was 20%. The ULD CT's diagnostic performance in joint reading was high for the primary endpoint (sensitivity = 90.9%, specificity = 100%, positive predictive value = 100%, negative predictive value = 97.8%), high for lung nodules, diffuse pleural thickening and calcified pleural plaques (sensitivity, specificity, PPV and NPV = 100%) and fair for asbestosis (sensitivity = 75%, specificity = 100%, PPV = 00%, NPV = 98.1%). Intra-reader accuracy between the ULD CT and the reference CT for the primary endpoint was 98% for the senior and 100% for the junior radiologist. Inter-reader agreement for the primary endpoint was almost perfect (Cohen's Kappa of 0.81). |
1 |
| 29. Kardos P, Berck H, Fuchs KH, et al. Guidelines of the German Respiratory Society for diagnosis and treatment of adults suffering from acute or chronic cough. Pneumologie. 64(11):701-11, 2010 Nov. |
Review/Other-Dx |
N/A |
To assist in ascertaining underlying causes and treating cough, in order to eliminate or minimize impairments of patients' health. |
No results stated in the abstract. |
4 |
| 30. Piccazzo R, Paparo F, Garlaschi G. Diagnostic accuracy of chest radiography for the diagnosis of tuberculosis (TB) and its role in the detection of latent TB infection: a systematic review. [Review]. J Rheumatol Suppl. 91:32-40, 2014 May. |
Review/Other-Dx |
67 paper articles |
To evaluate the role of chest radiography (CXR) in the diagnostic flow chart for tuberculosis (TB) infection, focusing on latent TB infection (LTBI) in patients requiring medical treatment with biological drugs. |
In recent findings, patients scheduled for immunomodulatory therapy with biologic drugs are a group at risk of TB reactivation and, in such patients,detection of LTBI is of great importance. CXR for diagnosis of pulmonary TB has good sensitivity, but poor specificity. Radiographic diagnosis of active disease can only be reliably made on the basis of temporal evolution of pulmonary lesions. In vivo tuberculin skin test and ex vivo interferon-g release assays are designed to identify development of an adaptive immune response, but not necessarily LTBI. Computed tomography (CT) is able to distinguish active from inactive disease. CT is considered a complementary imaging modality to CXR in the screening procedure to detect past and LTBI infection in specific subgroups of patients who have increased risk for TB reactivation, including those scheduled for medical treatment with biological drugs. |
4 |
| 31. Colaci M, Sebastiani M, Manfredi A, et al. Lung involvement in systemic sclerosis: role of high resolution computed tomography and its relationship with other pulmonary and clinico-serological features. J Biol Regul Homeost Agents. 28(3):481-8, 2014 Jul-Sep. |
Observational-Dx |
107 patients |
To investigate the characteristic of interstitial lung disease in a large series of systemic sclerosis (SSc) patients by means of HRCT and the correlations between functional lung parameters, serological features and the extent of lung involvement evaluated by high-resolution computed tomography (HRCT). |
One hundred and seven SSc patients, consecutively investigated by means of HRCT, standard chest X-ray, and pulmonary function tests, were retrospectively evaluated. Chest radiogram and HRCT scores were strongly associated (Pearson?'s r=0.82, p < .0001); moreover, the first significantly correlated with spirometric parameters, even if weakly. Anti-Scl70 and anti-centromere antibodies were associated with higher (p=0.01) and lower HRCT score (p=0.0002), respectively. The extension of interstitial lung involvement in SSc evaluated with HRCT is directly proportional to functional lung parameters. HRCT, spirometry and DLco should be considered essential in the core-set of non-invasive diagnostic tools for the first-line assessment of scleroderma lung involvement. |
2 |
| 32. Altenburg J, Wortel K, van der Werf TS, Boersma WG. Non-cystic fibrosis bronchiectasis: clinical presentation, diagnosis and treatment, illustrated by data from a Dutch Teaching Hospital. [Review]. Neth J Med. 73(4):147-54, 2015 May. |
Review/Other-Dx |
236 patients |
To describe the epidemiology, clinical presentation, diagnostic workup and treatment options in adult non-cystic fibrosis (non-CF) bronchiectasis (widening of mainly small and medium-sized bronchi as seen on chest computed tomography (CT) scan). |
No results stated in the abstract |
4 |
| 33. Choo JY, Lee KY, Yu A, et al. A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference. Eur Radiol. 26(9):3147-54, 2016 Sep. |
Observational-Dx |
149 patients |
To compare the diagnostic performance of digital tomosynthesis (DTS) and chest radiography for detecting airway abnormalities, using computed tomography (CT) as a reference. |
The sensitivity of DTS was higher (reader 1, 93.51 %; reader 2, 94.29 %) than chest radiography (68.83 %; 71.43 %) in detecting airway lesions. The diagnostic accuracy of DTS (90.91 %; 94.70 %) was also significantly better than that of radiography (78.03 %; 82.58 %, all p < 0.05). DTS image quality was significantly better than chest radiography (1.83, 2.74; p < 0.05) in the results of both readers. The inter-observer agreement with respect to DTS findings was moderate and superior when compared to radiography findings. |
2 |
| 34. Self WH, Courtney DM, McNaughton CD, Wunderink RG, Kline JA. High discordance of chest x-ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. Am J Emerg Med. 2013;31(2):401-405. |
Observational-Dx |
3423 patients |
To evaluate the diagnostic performance of chest x-ray (CXR) compared to computed tomography (CT) for detection of pulmonary opacities in adult emergency department (ED) patients. |
The study cohort included 3423 patients. Shortness of breath, chest pain and cough were the most common complaints, with 96.1% of subjects reporting at least one of these symptoms. Pulmonary opacities were visualized on 309 (9.0%) CXRs and 191 (5.6 %) CT scans. CXR test characteristics for detection of pulmonary opacities included: sensitivity 43.5% (95% CI, 36.4%-50.8%); specificity 93.0% (95% CI, 92.1%-93.9%); positive predictive value 26.9% (95% CI, 22.1%-32.2%); and negative predictive value 96.5% (95% CI, 95.8%-97.1%). |
3 |
| 35. Wielputz MO, Heusel CP, Herth FJ, Kauczor HU. Radiological diagnosis in lung disease: factoring treatment options into the choice of diagnostic modality. [Review]. Dtsch. Arztebl. int.. 111(11):181-7, 2014 Mar 14. |
Review/Other-Dx |
N/A |
To discuss the characteristics advantages and disadvantages that need to be considered in clinical decision-making for Chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI). |
There have been no more than a few large-scale, controlled comparative trials of different radiological techniques. Chest X-ray provides general orientation as an initial diagnostic study and is especially useful in the diagnosis of pneumonia, cancer, and chronic obstructive pulmonary disease (COPD). Multi-detector CT affords nearly isotropic spatial resolution at a radiation dose of only 0.2-5 mSv, much lower than before. Its main indications, according to current guidelines, are tumors, acute pulmonary embolism, pulmonary hypertension, pulmonary fibrosis, advanced COPD, and pneumonia in a high-risk patient. MRI is used in the diagnosis of cystic fibrosis, pulmonary embolism, pulmonary hypertension, and bronchial carcinoma. The positive predictive value (PPV) of a chest X-ray in outpatients with pneumonia is only 27% (gold standard, CT); in contrast, an initial, non-randomized trial of MRI in nosocomial pneumonia revealed a PPV of 95%. For the staging of mediastinal lymph nodes in bronchial carcinoma, MRI has a PPV of 88% and positron emission tomography with CT (PET/CT) has a PPV of 79%, while CT alone has a PPV of 41% (gold standard, histology). |
4 |
| 36. Youssef AA, Machaly SA, El-Dosoky ME, El-Maghraby NM. Respiratory symptoms in rheumatoid arthritis: relation to pulmonary abnormalities detected by high-resolution CT and pulmonary functional testing. Rheumatology International. 32(7):1985-95, 2012 Jul. |
Observational-Dx |
36 patients |
To investigate the prevalence and types of pulmonary involvement using high-resolution computed tomography scan (HRCT) and pulmonary function tests (PFT) and evaluate the association between respiratory symptoms and RA-lung disease in a group of Egyptian RA patients. |
Thirty-six RA patients were recruited; 34 females (94.4%) and 2 males (5.6%) with median age of 48.5 years, and none of them was smoker. Detailed medical and drug histories were obtained. PFT, plain X-ray of the chest, and HRCT were performed to all subjects involved. Nearly 64% of RA patients demonstrated abnormalities in PFT and 47% in HRCT. Mixed restrictive and obstructive pattern was the commonest. Nearly two-thirds of our patients reported one or more pulmonary symptom whether dyspnea, cough, wheezing, or phlegm. Dyspnea was the most frequent symptom. Respiratory symptoms were statistically more common in patients with lung disease. The advanced age, high radiological score, and severity of rheumatoid disease were found to be predictive of lung involvement. Among respiratory symptoms, dyspnea and cough were associated with any pulmonary abnormalities. When specific pulmonary abnormalities were considered, only dyspnea was identified as predictor for restriction. For obstructive abnormality, both cough and wheezing provided valid prediction. We conclude that pulmonary involvement is a common manifestation in Egyptian RA patients, and the pattern of involvement is generally consistent with other studies that were performed worldwide. Specific respiratory symptoms could be used as practical, easy, and cost-effective method, especially in older and with more severe RA patients, to discriminate patients in need of subsequent PFT and HRCT imaging. |
2 |
| 37. de Brito MC, Ota MK, Leitao Filho FS, Meirelles GS. Radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography. Radiol. Bras.. 50(1):26-31, 2017 Jan-Feb. |
Review/Other-Dx |
43 patients |
To evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT). |
For the measurement and appearance of bronchiectasis, the interobserver agreement was moderate (? = 0.45 and ? = 0.43, respectively), as was the intraobserver agreement (? = 0.54 and ? = 0.47, respectively). Agreement on the presence of mucous plugging was fair, for central distribution (overall interobserver agreement of 68.3% and ? = 0.39 for intraobserver agreement) and for peripheral distribution (? = 0.34 and ? = 0.35 for interobserver and intraobserver agreement, respectively). The agreement was also fair for peribronchial thickening (? = 0.21 and ? = 0.30 for interobserver and intraobserver agreement, respectively). There was fair interobserver and intraobserver agreement on the detection of opacities (? = 0.39 and 71.9%, respectively), ground-glass attenuation (64.3% and ? = 0.24, respectively), and cysts/bullae (? = 0.47 and ? = 0.44, respectively). Qualitative analysis of the HRCT findings of bronchiectasis and the resulting individual patient scores showed that there was an excellent correlation between the observers (intraclass correlation coefficient of 0.85 and 0.81 for interobserver and intraobserver agreement, respectively). |
4 |
| 38. Hochhegger B, Alves GR, Irion KL, et al. Computed tomographic pulmonary changes in patients with chronic rhinosinusitis. Br J Radiol. 88(1054):20150273, 2015 Oct. |
Review/Other-Dx |
123 patients |
To investigate whether patients with a diagnosis of chronic rhinosinusitis (CRS) show characteristic pulmonary changes on chest CT compared with a control group without sinusopathy. |
A total of 123 CT series (51.2% from male patients, mean age 41 ± 16 years) were reviewed, including those from 59 (48%) patients with a diagnosis of CRS. Patients with CRS were more likely than the control group to exhibit atelectasis, bronchiolectasis, centrilobular nodules and ground-glass opacities (all p < 0.05), with a significant predilection for middle lobe and lingular involvement observed (p < 0.001). Other abnormalities, such as bronchial wall thickening and air trapping, did not differ between groups. |
4 |
| 39. Grydeland TB, Dirksen A, Coxson HO, et al. Quantitative computed tomography measures of emphysema and airway wall thickness are related to respiratory symptoms. American Journal of Respiratory & Critical Care Medicine. 181(4):353-9, 2010 Feb 15. |
Observational-Dx |
463 subjects with COPD and 488 subjects without COPD |
To describe the independent relationship between respiratory symptoms of COPD and quantitative HRCT measures of emphysema (percent low-attenuation areas less than –950 Hounsfield units) and airway wall thickness at an internal perimeter of 10 mm. Also assessed whether these relationships varied between subjects with and without COPD, and between sexes. |
Median (25th percentile, 75th percentile) percent low-attenuation areas less than -950 Hounsfield units was 7.0 (2.2, 17.8) in subjects with COPD and 0.5 (0.2, 1.3) in subjects without COPD. Mean (standard deviation) standardized airway wall thickness at an internal perimeter of 10 mm was 4.94 (0.33) mm in subjects with COPD and 4.77 (0.29) in subjects without COPD. Both percent low-attenuation areas and airway wall thickness at an internal perimeter of 10 mm were independently and significantly related to the level of dyspnea among subjects with COPD, even after adjustments for percent predicted FEV in 1 second. Airway wall thickness at an internal perimeter of 10 mm was significantly related to cough and wheezing in subjects with COPD, and to wheezing in subjects without COPD. Odds ratios (95% CI) for increased dyspnea in subjects with COPD and in subjects without COPD were 1.9 (1.5-2.3) and 1.9 (0.6-6.6) per 10% increase in percent low-attenuation areas, and 1.07 (1.01-1.14) and 1.11 (0.99-1.24) per 0.1-mm increase in airway wall thickness at an internal perimeter of 10 mm, respectively. Quantitative CT assessment of the lung parenchyma and airways may be used to explain the presence of respiratory symptoms beyond the information offered by spirometry. |
3 |
| 40. Wilsher M, Voight L, Milne D, et al. Prevalence of airway and parenchymal abnormalities in newly diagnosed rheumatoid arthritis. Respiratory Medicine. 106(10):1441-6, 2012 Oct. |
Observational-Dx |
60 patients |
To determine the prevalence of airway and parenchymal abnormalities in newly diagnosed patients with RA and to correlate these with clinical measures of RA severity and laboratory tests. |
Eighteen (30%) patients reported respiratory symptoms: dyspnoea (11), cough (11), and wheeze (8). Twelve (20%) patients had physiologic evidence of airflow obstruction and 24 (40%) had reduced gas transfer. The prevalence of HRCT abnormalities (in any lobe) was as follows: decreased attenuation 67%, bronchiectasis 35%, bronchial wall thickening 50%, ground glass opacification 18%, reticular changes 12%. All abnormalities were more common in the lower lobes. With the exception of reduced DLCO, there were no significant differences in the prevalence of HRCT patterns or lung function parameters between smokers and non smokers. Anti-CCP antibodies and rheumatoid factor (RF) correlated strongly with DLCO and variably with other physiologic measures but poorly with radiologic abnormalities. |
4 |
| 41. Morris MJ, Dodson DW, Lucero PF, et al. Study of active duty military for pulmonary disease related to environmental deployment exposures (STAMPEDE). Am J Respir Crit Care Med. 190(1):77-84, 2014 Jul 01. |
Observational-Dx |
50 patients |
To evaluate new respiratory complaints in military personnel returning from Southwest Asia to determine potential etiologies for symptoms. |
Prospective standardized evaluation included full pulmonary function testing, high-resolution chest tomography, methacholine challenge testing, and fiberoptic bronchoscopy with bronchoalveolar lavage. Other procedures including lung biopsy were performed if clinically indicated. Fifty patients completed the study procedures. A large percentage (42%) remained undiagnosed, including 12% with normal testing and an isolated increase in lavage neutrophils or lymphocytes. Twenty (40%) patients demonstrated some evidence of airway hyperreactivity to include eight who met asthma criteria and two with findings secondary to gastroesophageal reflux. Four (8%) additional patients had isolated reduced diffusing capacity and the remaining six had other miscellaneous airway disorders. No patients were identified with diffuse parenchymal disease on the basis of computed tomography imaging. A significant number (66%) of this cohort had underlying mental health and sleep disorders. |
2 |
| 42. Winter DH, Manzini M, Salge JM, et al. Aging of the lungs in asymptomatic lifelong nonsmokers: findings on HRCT. Lung. 193(2):283-90, 2015 Apr. |
Observational-Dx |
N/A |
To report lung parenchymal findings on high-resolution computed tomography (HRCT) in a population of asymptomatic, never-smoker urban dwellers aged 65 years and older. |
Forty-seven older and 24 younger subjects were included in this analysis. A higher proportion of women and a longer history of urban dwelling were present in the older group. Parenchymal findings were more prevalent in the older group (78.7 vs. 25% in the younger group; p < 0.001). Parenchymal bands (59.6 vs. 25%; p = 0.007), ground-glass opacities (25.5 vs. 0%; p = 0.006), and septal lines (21.3 vs. 0%; p = 0.013) were more prevalent in the elderly. When only subjects aged 75 years and older were considered as the older group, micronodules, reticular opacities, cysts, and bronchiectases (19.1 vs. 0 % for all comparisons; p = 0.04) were also more frequently found among the elderly. |
2 |
| 43. Wachsmann JW, Gerbaudo VH. Thorax: normal and benign pathologic patterns in FDG-PET/CT imaging. [Review]. Pet Clinics. 9(2):147-68, 2014 Apr. |
Review/Other-Dx |
N/A |
To describe the normal patterns of thoracic (18)F-fluorodeoxyglucose (FDG) biodistribution, and expands on the role of FDG-PET/computed tomography (CT) for the evaluation of patients suffering from a spectrum of benign pathologic conditions that affect the chest. |
No results stated in the abstract. |
4 |
| 44. Ackman JB, Wu CC, Halpern EF, Abbott GF, Shepard JA. Nonvascular thoracic magnetic resonance imaging: the current state of training, utilization, and perceived value: survey of the Society of Thoracic Radiology membership. J Thorac Imaging. 29(4):252-7, 2014 Jul. |
Review/Other-Dx |
693 patients |
To determine the current state of training, utilization, and perceived value of nonvascular thoracic magnetic resonance imaging (MRI). |
The survey response rate was 27% (190/693). Thirty-seven percent (67/180) of respondents reported that they interpreted and reported zero thoracic MRIs and 64% (116/182) interpreted or reported <10 MRIs over the prior year. The perceived value of thoracic MRI was highest for chest wall and neurovascular involvement and evaluation of the mediastinum, particularly thymus, next highest for assessment of pleural or diaphragmatic lesions, and lowest for assessment of lung function with hyperpolarized gases. Seventy-three percent (121/166) of respondents felt it would be of value to increase utilization of thoracic MRI. Perceived obstacles to increasing thoracic MRI utilization included lack of: awareness of referring health care providers as to the value of thoracic MRI (59%, 98/166), radiologist proficiency or comfort with thoracic MRI (46%, 77/166), standardized protocols (38%, 64/166), technologist experience (38%, 63/166), and sufficient training during residency and/or fellowship (32%, 54/166). Twenty-five percent (41/166) of respondents reported insufficient thoracic MRI literature and limited CME courses and lectures in this field as an additional impediment. |
4 |
| 45. Theilmann RJ, Darquenne C, Elliott AR, Bailey BA, Conrad DJ. Characterizing Lung Disease in Cystic Fibrosis with Magnetic Resonance Imaging and Airway Physiology. PLoS ONE. 11(6):e0157177, 2016. |
Observational-Dx |
12 patients |
To establish a non-invasive quantitative MRI technique to monitor lung health in patients with CF and correlate MR metrics with airway physiology as measured by multiple breath washout (MBW). |
Spirometry and MBW data were also acquired for each subject. Ventilation inhomogeneities were quantified by the lung clearance index (LCI) and by indices Scond* and Sacin* that assess inhomogeneities in the conducting (central) and acinar (peripheral) lung regions, respectively. MBW indices and mFLD at TLC (both regions) were significantly elevated in CF (p<0.01) compared to controls. The mFLD at TLC (central: R = 0.82) and the FRC-to-TLC mFLD ratio (peripheral: R = -0.77) were strongly correlated with Scond* and LCI. CF patients had high lung water content at TLC when compared to controls. This is likely due to the presence of retained airway secretions and airway wall edema (more water) and to limited expansions of air trapping areas (less air) in CF subjects. FRC-to-TLC ratios of mFLD strongly correlated with central ventilation inhomogeneities. These combined measures may provide a useful marker of both retained mucus and air trapping in CF lungs. |
2 |
| 46. Renz DM, Scholz O, Bottcher J, et al. Comparison between magnetic resonance imaging and computed tomography of the lung in patients with cystic fibrosis with regard to clinical, laboratory, and pulmonary functional parameters. Invest Radiol. 50(10):733-42, 2015 Oct. |
Observational-Dx |
30 patients |
To evaluate whether magnetic resonance imaging (MRI) is effective as computed tomography (CT) in determining morphologic and functional pulmonary changes in patients with cystic fibrosis (CF) in association with multiple clinical parameters. |
The overall modified Helbich CT score had a mean (SD) of 15.3 (4.8) (range, 3-21) and median of 16.0 (interquartile range [IQR], 6.3). The overall modified Helbich MR score showed slightly, not significantly, lower values (Wilcoxon rank sum test and Student t test; P > 0.05): mean (SD) of 14.3 (4.7) (range, 3-20) and median of 15.0 (IQR, 7.3). Without assessment of perfusion, the overall Eichinger score resulted in the following values for CT vs MR examinations: mean (SD), 20.3 (7.2) (range, 4-31); and median, 21.0 (IQR, 9.5) vs mean (SD), 19.5 (7.1) (range, 4-33); and median, 20.0 (IQR, 9.0). All differences between CT and MR examinations were not significant (Wilcoxon rank sum tests and Student t tests; P > 0.05). In general, the correlations of the CT scores (overall and different imaging parameters) to the clinical parameters were slightly higher compared to the MRI scores. However, if all additional MRI parameters were integrated into the scoring systems, the correlations reached the values of the CT scores. The overall image quality was significantly higher for the CT examinations compared to the MRI sequences. |
2 |
| 47. Ohno Y, Koyama H, Yoshikawa T, et al. Pulmonary high-resolution ultrashort TE MR imaging: Comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases. J Magn Reson Imaging. 43(2):512-32, 2016 Feb. |
Observational-Dx |
85 patients |
To determine the accuracy of pulmonary MR imaging with ultrashort echo time (UTE) for lung and mediastinum assessments using computed tomography (CT) as the reference standard, for various pulmonary parenchyma diseases. |
Intermethod agreements between pulmonary MR imaging and standard-dose and low-dose CT were significant and either substantial or almost perfect (0.67 = ? = 0.98; P < 0.0001). Areas under the curve for emphysema or bullae, bronchiectasis or traction bronchiectasis and reticular opacity on standard-dose CT were significantly larger than those on low-dose CT (emphysema or bullae: P = 0.0002; reticular opacity: P < 0.0001) and pulmonary MR imaging (emphysema or bullae: P < 0.0001; bronchiectasis: P = 0.008; reticular opacity: P < 0.0001). |
2 |
| 48. Kern AL, Vogel-Claussen J. Hyperpolarized gas MRI in pulmonology. [Review]. Br J Radiol. 91(1084):20170647, 2018 Apr. |
Review/Other-Dx |
N/A |
To discuss the introduction to the MR physics of hyperpolarized media and presents the current state of hyperpolarized gas MRI of 3Headvasd and 129Xe in pulmonology. |
No results stated in the abstract. |
4 |
| 49. Harle ASM, Buffin O, Burnham J, Molassiotis A, Blackhall FH, Smith JA. The prevalence of cough in lung cancer: Its characteristics and predictors. Journal of Clinical Oncology 2014;32:162-62. |
Observational-Dx |
223 patients |
To determine its prevalence and characteristics (severity, impact and potential predictors) in patients undergoing standard treatment and follow up. |
Of 223 consecutive LC outpatients approached, the prevalence of cough was 57% (128/223); 202/223 (86%) consented to further data collection (study population) and of these 115. |
2 |
| 50. Molassiotis A, Smith JA, Mazzone P, Blackhall F, Irwin RS, CHEST Expert Cough Panel. Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer: CHEST Guideline and Expert Panel Report. Chest. 151(4):861-874, 2017 Apr. |
Review/Other-Dx |
17 studies |
To update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic. |
The Cochrane systematic review identified 17 trials of primarily low-quality evidence. Such evidence was related to both nonpharmacologic (cough suppression) and pharmacologic (demulcents, opioids, peripherally acting antitussives, or local anesthetics) treatments, as well as endobronchial brachytherapy. |
4 |
| 51. Tutkun E, Abusoglu S, Yilmaz H, et al. Farewell to an old friend: chest X-ray vs high-resolution computed tomography in welders' lung disease. Clin Respir J. 8(2):220-4, 2014 Apr. |
Review/Other-Dx |
74 patients |
To compare the diagnostic performance of chest X-ray (CXR) and high-resolution computed tomography (HRCT) for welders' lung disease. |
The mean age for 74 welders was 40.7 years. The mean duration of exposure was 18.9 years. Although all were found to be nonpathological on the CXR, 27 mild nodular and nine mild linear opacities, five emphysematous changes, three ground glass infiltrates and one pleural thickening were detected by HRCT. |
4 |
| 52. Akhtar N, Bansal JG. Risk factors of Lung Cancer in nonsmoker. Curr Probl Cancer 2017;41:328-39. |
Review/Other-Dx |
N/A |
To provide a comprehensive review of various risk factors and the underlying molecular mechanisms responsible for increasing the incidence of lung cancer. |
The pathologic, histologic, and genetic differences exist with lung cancer among smokers and nonsmokers. A better understanding of the risk factors, differences in pathology and molecular features of lung cancer in smokers and nonsmokers and the mode of action of various carcinogens will facilitate the prevention and management of lung cancer. |
4 |
| 53. Achilleos A.. Evidence-based Evaluation and Management of Chronic Cough. [Review]. Medical Clinics of North America. 100(5):1033-45, 2016 Sep. |
Review/Other-Dx |
N/A |
To discuss evidence based evaluation and management of chronic cough. |
No results state din the abstract. |
4 |
| 54. American College of Radiology. ACR–STR Practice Parameter for the Performance of High-Resolution Computed Tomography (HRCT) of the Lungs in Adults. Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/HRCT-Lungs.pdf. |
Review/Other-Dx |
N/A |
Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 55. Abrass LJ, Chandra RK, Conley DB, Tan BK, Kern RC. Factors associated with computed tomography status in patients presenting with a history of chronic rhinosinusitis. Int Forum Allergy Rhinol. 1(3):178-82, 2011 May-Jun. |
Observational-Dx |
100 patients |
To investigate the utility of point of care computed tomography (POC-CT) in resolving this issue. |
POC-CT was considered positive in 49% of patients. Univariate analysis revealed that patients complaining nasal obstruction were significantly more likely to have a positive scan (odds ratio [OR], 2.74; p = 0.047), while those with postnasal drip (OR, 0.44; p = 0.047) or cough (OR, 0.17; p = 0.03) were less likely to have positive scan results. In the multivariate model, these trends persisted without reaching statistical significance. Under univariate analysis, patients who were prescribed antibiotics, oral steroids, or nasal steroids at this initial visit were more likely to have had a positive CT. These trends also persisted in the multivariate model, with significance observed for the association between antibiotic prescription and a positive scan (p = 0.001). |
2 |
| 56. Conley D, Pearlman A, Zhou K, Chandra R, Kern R. The role of point-of-care CT in the management of chronic rhinosinusitis: a case-control study. Ear Nose Throat J. 90(8):376-81, 2011 Aug. |
Observational-Dx |
40 patients |
To present new patients who (1) met the symptom criteria for CRS but whose endoscopy results were negative (i.e., no pus, polyps, or edema), (2) had not undergone any previous CT scanning or sinus surgery, and (3) had undergone POC-CT during their initial evaluation. |
A comparison group was made up of 40 patients from the pre-POC-CT era whose initial treatment had been based on the history alone; these patients underwent CT after their medical therapy had been completed. In the pre-POC-CT group, follow-up CT showed evidence of inflammatory disease in 24 patients (60%), 13 of whom (54.2%) had received an antibiotic at their initial visit, including 2 who had received an oral steroid, as well; among the 16 patients whose follow-up CT was negative, only 2 (12.5%) had received an antibiotic, neither of whom received an oral steroid. In the POC-CT group, 27 of 40 patients (67.5%) had positive findings at the initial visit, and 14 of them (51.9%) received an antibiotic and an oral steroid; none of the 13 patients in whom POC-CT was negative was prescribed either agent. Thus, the incidence of scan positivity and antibiotic use was similar in the two cohorts. Also, patients who met the symptomatic definition of CRS but who were lacking in objective endoscopic findings were more likely to have received an oral steroid when POC-CT was part of the initial assessment; these patients were also less likely to be lost to follow-up. Ongoing prospective studies will better characterize the magnitude of these effects on long-term outcomes, antibiotic resistance, healthcare costs, and overall quality of care. |
2 |
| 57. Moore P, Blakley B, Meen E. Clinical predictors of chronic rhinosinusitis: do the Canadian clinical practice guidelines for acute and chronic rhinosinusitis predict CT-confirmation of disease?. J Otolaryngol Head Neck Surg. 46(1):65, 2017 Dec 04. |
Observational-Dx |
126 patients |
To determine whether symptom and endoscopic criteria, as defined by the Canadian Rhinosinusitis Guidelines, accurately predict CT-confirmed CRS diagnosis. |
Overall, 56.3% of patients had a CT-confirmed diagnosis of CRS. With the exception of nasal polyps, none of the symptom or endoscopic criteria had a statistically significant correlation with positive CT sinuses. For symptom criteria, positive predictive values ranged from 52.4% to 63.4%; likelihood ratios ranged from 0.85 to 1.34. For endoscopic criteria, positive predictive values and likelihood ratios were 71.4% and 1.94 (edema); 63.0% and 1.32 (discharge); and 92.9% and 10.1 (nasal polyps). 35.2% of patients with CT-confirmed CRS had normal endoscopic exams. |
2 |
| 58. Horwitz Berkun R, Polak D, Shapira L, Eliashar R. Association of dental and maxillary sinus pathologies with ear, nose, and throat symptoms. Oral Dis. 24(4):650-656, 2018 May. |
Observational-Dx |
81 patients |
To investigate the correlation between cone-beam computerized tomography (CBCT) findings in the maxillary sinus, ear-nose-throat (ENT) symptoms and dental pathologies in asymptomatic patients. |
Despite being asymptomatic, most of the 81 patients reported ENT symptoms in the questionnaire, thereby indicating that these symptoms were mainly subclinical. A significant correlation was found between the presence of polyps in the sinus and a decrease in smell/taste. Obstruction of the sinus meatus was associated with coughing; turbidity was associated with ear congestion. Thickening of the Schneiderian membrane showed an association with both coughing and ear congestion. The mean number of missing posterior teeth correlated with postnasal drip and nasal congestion. Periapical pathology was associated with nasal discharge/runny nose. |
2 |
| 59. Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol 2016;6 Suppl 1:S22-209. |
Review/Other-Dx |
144 topics |
To discuss the International Consensus Statement on Allergy and Rhinology. |
As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too often the foundation upon which these recommendations are based is comprised of lower level evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. |
4 |
| 60. Groves AM, Win T, Screaton NJ, et al. Idiopathic pulmonary fibrosis and diffuse parenchymal lung disease: implications from initial experience with 18F-FDG PET/CT. Journal of Nuclear Medicine. 50(4):538-45, 2009 Apr. |
Observational-Dx |
36 consecutive patients |
To evaluate integrated FDG-PET/CT in patients with IPF and diffuse parenchymal lung disease. |
Raised pulmonary FDG metabolism in 36/36 patients was observed. The parenchymal pattern on HRCT at the site of maximal FDG metabolism was predominantly ground-glass (7/36), reticulation/honeycombing (26/36), and mixed (3/36). The mean SUVmax in patients with ground-glass and mixed patterns was 2.0 +/- 0.4, and in reticulation/honeycombing it was 3.0 +/- 1.0 (Mann-Whitney U test, P=0.007). The mean SUVmax in patients with IPF was 2.9 +/- 1.1, and in other diffuse parenchymal lung disease it was 2.7 +/- 0.9 (Mann-Whitney U test, P=0.862). The mean mediastinal lymph node SUVmax (2.7 +/- 1.3) correlated with pulmonary SUVmax (r = 0.63, P<0.001). Pulmonary FDG uptake correlated with the global health score (r = 0.50, P=0.004), forced VC (r = 0.41, P=0.014), and transfer factor (r = 0.37, P=0.042). Increased pulmonary FDG metabolism in all patients with IPF and other forms of diffuse parenchymal lung disease was observed. Pulmonary FDG uptake predicts measurements of health and lung physiology in these patients. FDG metabolism was higher when the site of maximal uptake corresponded to areas of reticulation/honeycomb on HRCT than to those with ground-glass patterns. |
3 |
| 61. Yadav M, Karkhanis VS, Basu S, Joshi JM. Potential Clinical Utility of FDG-PET in Non-malignant Pulmonary Disorders: A Pilot Study. Indian J Chest Dis Allied Sci. 58(3):165-172, 2016 Jul. |
Observational-Dx |
50 patients |
To investigate its utility in the diagnosis and monitoring of various benign pulmonary diseases. |
All patients showed increased FDG uptake in the lung corresponding to CT findings. Of the 9 patients with sarcoidosis stage 1 (n=1), stage 2 (n=3) and stage 3 (n=5), additional uptake in the myocardium and thyroid was noted in two patients which resulted in a change in the modality of treatment. Repeat FDG scan post-treatment showed decreased uptake in all patients which was consistent with clinico-radiologic, microbiological or spirometry findings. Increased uptake was seen in one patient with pulmonary tuberculosis (TB) and in one patient with TB mediastinal lymphadenopathy at the end of intensive phase discordant with clinical and microbiological response. Of nine cases of idiopathic interstitial pneumonias (IIPs), additional intense FDG uptake was found in two cases which corresponded to the areas of honeycombing. |
2 |
| 62. Win T, Thomas BA, Lambrou T, et al. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients. European Journal of Nuclear Medicine & Molecular Imaging. 41(2):337-42, 2014 Feb. |
Observational-Dx |
25 patients |
To investigate the PET signal at sites of normal-appearing lung on high-resolution computed tomography (HRCT) in pulmonary fibrosis (IPF). |
The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p < 0.001). The TF-corrected mean SUV in the controls was 2.24 ± 0.29 and 3.24 ± 0.84 in IPF patients (p < 0.001). |
2 |
| 63. Irwin RS, French CL, Curley FJ, Zawacki JK, Bennett FM. Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects. Chest. 104(5):1511-7, 1993 Nov. |
Observational-Dx |
12 ptients |
To evaluate a group of patients with chronic cough likely to be due to GER with extensive gastrointestinal and respiratory studies and then observed their response to antireflux therapy. |
Gastroesophageal reflux was determined to cause cough in all subjects based on disappearance of cough with antireflux therapy. It was clinically "silent" in 75 percent. The EPM was the test most frequently abnormal (sensitivity, 92 percent). Distal esophageal data revealed that 10 of 12 subjects had GER-induced coughs (12 +/- 12) while only 7 of 12 had an abnormal esophageal pH conventional parameter (eg, percent time pH < 4). Compared with the distal esophagus, GER to the proximal esophagus occurred (p = 0.017) and induced cough (p = 0.004) less often. Compared with baseline (9.3 +/- 17.6), there were no differences in coughs induced by the infusion of saline solution (9.2 +/- 15.9) or acid (15.1 +/- 26.7); the number of coughs induced by acid was negatively correlated with distal esophageal acid-GER events during EPM (r = -0.64, p = 0.01). Neither bronchoscopy nor chest radiographs were consistent with aspiration. |
2 |
| 64. Sidhwa F, Moore A, Alligood E, Fisichella PM. Diagnosis and Treatment of the Extraesophageal Manifestations of Gastroesophageal Reflux Disease. [Review]. Annals of Surgery. 265(1):63-67, 2017 01. |
Review/Other-Dx |
128 articles |
To review the clinical presentation, diagnosis, and treatment options available for management of extraesophageal manifestations of gastroesophageal reflux disease (GERD) and to compare the most recent technological advances to the existing guidelines. |
One hundred twenty-eight articles met criteria for analysis. Our findings show that the diagnosis of cough, LPR, or asthma due to gastroesophageal reflux is difficult, as no criterion standard test exits. Also, patients often present without heartburn or regurgitation typical of GERD. Combined multichannel intraluminal impedance, the pH (MII-pH) monitoring system, and the symptom association probability (SAP) test might distinguish extraesophageal manifestations of reflux from idiopathic chronic cough, laryngitis due to other causes, and atopic asthma. In addition, extraesophageal manifestations of reflux are most effectively diagnosed with a stepwise approach incorporating empiric treatment and antisecretory therapy, combined MII-pH monitoring, and surgical intervention in few selected cases. |
4 |
| 65. Cardasis JJ, MacMahon H, Husain AN. The spectrum of lung disease due to chronic occult aspiration. Annals of the American Thoracic Society. 11(6):865-73, 2014 Jul. |
Review/Other-Dx |
25 patients |
To analyze a series of cases of patients with chronic occult aspiration to better define the disease process. |
Among patients with chronic occult aspiration, there was a high prevalence of gastroesophageal reflux disease (96%), esophageal dysfunction (40%), oropharyngeal/laryngeal dysfunction (40%), hiatal hernias (32%), obstructive sleep apnea (32%), and obesity (52%). The radiologic presentation was typically one of multilobar centrilobular nodularity, tree-in-bud, and airway thickening, with a subset of patients having evidence of fibrosis. The disease presented pathologically with exogenous lipoid pneumonia, poorly formed granulomas, and foreign body-type multinucleated giant cells with or without foreign material. Pathologic fibrosis was also seen. |
4 |
| 66. Aksu O, Songur N, Songur Y, et al. Is gastroesophageal reflux contribute to the development chronic cough by triggering pulmonary fibrosis. Turk J Gastroenterol. 25 Suppl 1:48-53, 2014 Dec. |
Observational-Dx |
21 patients |
To investigate if pulmonary fibrosis is involved in the pathogenesis of chronic cough due to Gastroesophageal Reflux. |
Reflux extending into the proximal esophagus was noted in 52.5%, and posterior laryngitis was present in 90.5% of the patients. No evidence of pulmonary aspiration was noted in the patients with reflux on scintigraphic examination. No significant difference was found between the GER and control groups in terms of cellular content, IL-1ß and TNF-a levels or mean T cell subsets and B cell counts in bronchoalveolar lavage fluid. Forced expiratory volume in one second, forced vital capacity FEV1/FVC, total lung capacity, and carbon monoxide diffusion capacity values were within normal limits in the gastroesophageal reflux group. |
4 |
| 67. Kahrilas PJ, Altman KW, Chang AB, et al. Chronic Cough Due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report. Chest. 150(6):1341-1360, 2016 Dec. |
Review/Other-Tx |
14 studies |
To update the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome. |
We found no high-quality studies pertinent to either question. From available randomized controlled trials (RCTs) addressing question #1, we concluded that (1) there was a strong placebo effect for cough improvement; (2) studies including diet modification and weight loss had better cough outcomes; (3) although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, proton pump inhibitors (PPIs) demonstrated no benefit when used in isolation; and (4) because of potential carryover effect, crossover studies using PPIs should be avoided. For question #2, we concluded from the available observational trials that (1) an algorithmic approach to management resolved chronic cough in 82% to 100% of instances; (2) cough variant asthma and upper airway cough syndrome (UACS) (previously referred to as postnasal drip syndrome) from rhinosinus conditions were the most commonly reported causes; and (3) the reported prevalence of reflux-cough syndrome varied widely. |
4 |
| 68. Nin CS, Marchiori E, Irion KL, et al. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough. J Bras Pneumol 2013;39:686-91. |
Observational-Dx |
95 patients |
To assess the routine use of barium swallow study in patients with chronic cough. |
The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6%) of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6%) of the patients, whereas the treatment was ineffective in 1 (8.4%). We observed no complications related to barium swallow, such as contrast aspiration. |
4 |
| 69. Amalachandran J, Simon S, Elangoven I, Jain A, Sivathapandi T. Scintigraphic Evaluation of Esophageal Motility and Gastroesophageal Reflux in Patients Presenting with Upper Respiratory Tract Symptoms. Indian J. Nucl. Med.. 33(1):25-31, 2018 Jan-Mar. |
Observational-Dx |
30 patients |
To evaluate the findings and utility of esophageal transit scintigraphy (ETS) and gastroesophageal reflux scintigraphy (GES) in patients presenting with upper respiratory tract (URT) symptoms suspected to be due to gastroesophageal reflux (GER) disease. |
Significant correlation was found between GER and NPL in 28/30 patients. More the grade of reflux, more severe was the NPL findings. Two patients with Grade II reflux had normal NPL suggesting structural inflammatory changes due to acidic pH of refluxate which have not yet manifested or symptoms could be due to nonacid refluxate. Incidence of esophageal motility disorder was statistically significant in patients with GER disease (GERD). Patients who had symptoms, but no demonstrable GER showed delayed ET in supine position suggesting the presence of esophageal motility disorder even before GERD. |
2 |
| 70. Akers SR, Panchal V, Ho VB, et al. ACR Appropriateness Criteria R Chronic Chest Pain-High Probability of Coronary Artery Disease. [Review]. J. Am. Coll. Radiol.. 14(5S):S71-S80, 2017 May. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for chronic chest pain, high probability of coronary artery disease/ |
No results stated in abstract. |
4 |
| 71. McComb BL, Ravenel JG, Steiner RM, et al. ACR Appropriateness Criteria® Chronic Dyspnea-Noncardiovascular Origin. J Am Coll Radiol 2018;15:S291-S301. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for chronic dyspnea-noncardiovascular origin. |
No results stated in abstract. |
4 |
| 72. Expert Panel on Cardiac Imaging:, Vogel-Claussen J, Elshafee ASM, et al. ACR Appropriateness Criteria R Dyspnea-Suspected Cardiac Origin. [Review]. J. Am. Coll. Radiol.. 14(5S):S127-S137, 2017 May. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for dyspnea-suspected cardiac origin. |
No results stated in abstract. |
4 |
| 73. Kirsch J, Brown RKJ, Henry TS, et al. ACR Appropriateness Criteria R Acute Chest Pain-Suspected Pulmonary Embolism. J. Am. Coll. Radiol.. 14(5S):S2-S12, 2017 May. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for acute chest pain-suspected pulmonary embolism. |
No results stated in abstract. |
4 |
| 74. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
