Diagnostic accuracy of a velcro sound detector (VECTOR) for interstitial lung disease in rheumatoid arthritis patients: the InSPIRAtE validation study (INterStitial pneumonia in rheumatoid ArThritis with an electronic device)

GISEA (Gruppo Italiano Studio Early Arthritis)

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. The aim of the present investigation was to validate the diagnostic accuracy of VECTOR in a larger population of RA patients, compared with that of the reference standard of HRCT, from a multicentre study.

METHODS: To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR.

RESULTS: Fifty-nine of 137 patients showed ILD (43.1%). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9% and a sensitivity and specificity of 93.2 and 76.9%, respectively.

CONCLUSIONS: VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis. Moreover, early identification of RA-ILD could contribute to the design of prospective studies aimed at elucidating unclear aspects of the disease.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalBMC Pulmonary Medicine
Volume19
Issue number1
DOIs
Publication statusPublished - Jun 20 2019

Fingerprint

Validation Studies
Interstitial Lung Diseases
Rheumatoid Arthritis
Tomography
Equipment and Supplies
Respiratory Sounds
X-Rays
Stethoscopes
Auscultation
Lung
Multicenter Studies
Prospective Studies
Costs and Cost Analysis
Sensitivity and Specificity
Population

Keywords

  • Diagnostic accuracy
  • Interstitial lung disease
  • Rheumatoid arthritis
  • Velcro sound

Cite this

@article{c23e04d60fa34ff4ac294e190f821b70,
title = "Diagnostic accuracy of a velcro sound detector (VECTOR) for interstitial lung disease in rheumatoid arthritis patients: the InSPIRAtE validation study (INterStitial pneumonia in rheumatoid ArThritis with an electronic device)",
abstract = "BACKGROUND: Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. The aim of the present investigation was to validate the diagnostic accuracy of VECTOR in a larger population of RA patients, compared with that of the reference standard of HRCT, from a multicentre study.METHODS: To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR.RESULTS: Fifty-nine of 137 patients showed ILD (43.1{\%}). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9{\%} and a sensitivity and specificity of 93.2 and 76.9{\%}, respectively.CONCLUSIONS: VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis. Moreover, early identification of RA-ILD could contribute to the design of prospective studies aimed at elucidating unclear aspects of the disease.",
keywords = "Diagnostic accuracy, Interstitial lung disease, Rheumatoid arthritis, Velcro sound",
author = "A Manfredi and G Cassone and S Cerri and V Venerito and Fedele, {A L} and M Trevisani and F Furini and Olga Addimanda and F Pancaldi and {Della Casa}, G and R D'Amico and R Vicini and G Sandri and Paola Torricelli and I Celentano and A Bortoluzzi and N Malavolta and Riccardo Meliconi and F Iannone and E Gremese and F Luppi and C Salvarani and M Sebastiani and {GISEA (Gruppo Italiano Studio Early Arthritis)}",
year = "2019",
month = "6",
day = "20",
doi = "10.1186/s12890-019-0875-x",
language = "English",
volume = "19",
pages = "1--6",
journal = "BMC Pulmonary Medicine",
issn = "1471-2466",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Diagnostic accuracy of a velcro sound detector (VECTOR) for interstitial lung disease in rheumatoid arthritis patients: the InSPIRAtE validation study (INterStitial pneumonia in rheumatoid ArThritis with an electronic device)

AU - Manfredi, A

AU - Cassone, G

AU - Cerri, S

AU - Venerito, V

AU - Fedele, A L

AU - Trevisani, M

AU - Furini, F

AU - Addimanda, Olga

AU - Pancaldi, F

AU - Della Casa, G

AU - D'Amico, R

AU - Vicini, R

AU - Sandri, G

AU - Torricelli, Paola

AU - Celentano, I

AU - Bortoluzzi, A

AU - Malavolta, N

AU - Meliconi, Riccardo

AU - Iannone, F

AU - Gremese, E

AU - Luppi, F

AU - Salvarani, C

AU - Sebastiani, M

AU - GISEA (Gruppo Italiano Studio Early Arthritis)

PY - 2019/6/20

Y1 - 2019/6/20

N2 - BACKGROUND: Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. The aim of the present investigation was to validate the diagnostic accuracy of VECTOR in a larger population of RA patients, compared with that of the reference standard of HRCT, from a multicentre study.METHODS: To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR.RESULTS: Fifty-nine of 137 patients showed ILD (43.1%). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9% and a sensitivity and specificity of 93.2 and 76.9%, respectively.CONCLUSIONS: VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis. Moreover, early identification of RA-ILD could contribute to the design of prospective studies aimed at elucidating unclear aspects of the disease.

AB - BACKGROUND: Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. The aim of the present investigation was to validate the diagnostic accuracy of VECTOR in a larger population of RA patients, compared with that of the reference standard of HRCT, from a multicentre study.METHODS: To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR.RESULTS: Fifty-nine of 137 patients showed ILD (43.1%). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9% and a sensitivity and specificity of 93.2 and 76.9%, respectively.CONCLUSIONS: VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis. Moreover, early identification of RA-ILD could contribute to the design of prospective studies aimed at elucidating unclear aspects of the disease.

KW - Diagnostic accuracy

KW - Interstitial lung disease

KW - Rheumatoid arthritis

KW - Velcro sound

U2 - 10.1186/s12890-019-0875-x

DO - 10.1186/s12890-019-0875-x

M3 - Article

C2 - 31221137

VL - 19

SP - 1

EP - 6

JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

SN - 1471-2466

IS - 1

ER -