Assessing Mortality Models in Systemic Sclerosis-Related Interstitial Lung Disease

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: The gender, age, and lung physiology (GAP) model, interstitial lung diseases—GAP (ILD-GAP) model, and the smoking history, age, and diffusion capacity of the lung (SADL) model were compared using a systemic sclerosis-ILD (SSc-ILD) cohort to evaluate which best determined prognosis. Methods: The models were applied to a cohort of 179 patients with SSc seen at a tertiary care center within 1 year of ILD diagnosis. Demographics, clinical characteristics, and mortality were recorded. The performance of the models was assessed using standardized mortality ratios (SMR) of observed versus predicted outcomes for calibration and concordance (c)-statistics for discrimination. Results: SSc-ILD patients with usual interstitial pneumonia (31, 17%) had a higher mortality than those with non-specific interstitial pneumonia (147, 83%) (hazard ratio 2.27; 95%CI 1.03–4.97). All 3 models had comparable discrimination (c = 0.72, 0.72, and 0.71, respectively). Regarding calibration, the ILD-GAP model underestimated mortality (SMR 1.50; 95%CI 1.05–2.14). Calibration was acceptable for SADL (SMR 1.00; 95%CI 0.70–1.44) and GAP (SMR 0.90; 95%CI 0.63–1.29). The SADL model underestimated mortality in Stage I ILD. Conclusions: The ILD-GAP model underestimated mortality, and the SADL model underestimated mortality in certain subgroups. However, the GAP model performed well in this cohort, providing the best prognostic information for SSc-ILD.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalLung
DOIs
StateAccepted/In press - May 21 2018

Fingerprint

Systemic Scleroderma
Interstitial Lung Diseases
Mortality
Lung
Calibration
Lung Volume Measurements
Idiopathic Pulmonary Fibrosis
Tertiary Care Centers
Smoking
History
Demography

Keywords

  • Interstitial lung disease
  • Mortality modeling
  • Non-specific interstitial pneumonia
  • Systemic sclerosis
  • Usual interstitial pneumonia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{7299959ac004475583cc6b5ac9ecfbfd,
title = "Assessing Mortality Models in Systemic Sclerosis-Related Interstitial Lung Disease",
abstract = "Purpose: The gender, age, and lung physiology (GAP) model, interstitial lung diseases—GAP (ILD-GAP) model, and the smoking history, age, and diffusion capacity of the lung (SADL) model were compared using a systemic sclerosis-ILD (SSc-ILD) cohort to evaluate which best determined prognosis. Methods: The models were applied to a cohort of 179 patients with SSc seen at a tertiary care center within 1 year of ILD diagnosis. Demographics, clinical characteristics, and mortality were recorded. The performance of the models was assessed using standardized mortality ratios (SMR) of observed versus predicted outcomes for calibration and concordance (c)-statistics for discrimination. Results: SSc-ILD patients with usual interstitial pneumonia (31, 17{\%}) had a higher mortality than those with non-specific interstitial pneumonia (147, 83{\%}) (hazard ratio 2.27; 95{\%}CI 1.03–4.97). All 3 models had comparable discrimination (c = 0.72, 0.72, and 0.71, respectively). Regarding calibration, the ILD-GAP model underestimated mortality (SMR 1.50; 95{\%}CI 1.05–2.14). Calibration was acceptable for SADL (SMR 1.00; 95{\%}CI 0.70–1.44) and GAP (SMR 0.90; 95{\%}CI 0.63–1.29). The SADL model underestimated mortality in Stage I ILD. Conclusions: The ILD-GAP model underestimated mortality, and the SADL model underestimated mortality in certain subgroups. However, the GAP model performed well in this cohort, providing the best prognostic information for SSc-ILD.",
keywords = "Interstitial lung disease, Mortality modeling, Non-specific interstitial pneumonia, Systemic sclerosis, Usual interstitial pneumonia",
author = "Mango, {Robert L.} and Matteson, {Eric Lawrence} and Cynthia Crowson and Ryu, {Jay H} and Ashima Makol",
year = "2018",
month = "5",
day = "21",
doi = "10.1007/s00408-018-0126-6",
language = "English (US)",
pages = "1--8",
journal = "Lung",
issn = "0341-2040",
publisher = "Springer New York",

}

TY - JOUR

T1 - Assessing Mortality Models in Systemic Sclerosis-Related Interstitial Lung Disease

AU - Mango, Robert L.

AU - Matteson, Eric Lawrence

AU - Crowson, Cynthia

AU - Ryu, Jay H

AU - Makol, Ashima

PY - 2018/5/21

Y1 - 2018/5/21

N2 - Purpose: The gender, age, and lung physiology (GAP) model, interstitial lung diseases—GAP (ILD-GAP) model, and the smoking history, age, and diffusion capacity of the lung (SADL) model were compared using a systemic sclerosis-ILD (SSc-ILD) cohort to evaluate which best determined prognosis. Methods: The models were applied to a cohort of 179 patients with SSc seen at a tertiary care center within 1 year of ILD diagnosis. Demographics, clinical characteristics, and mortality were recorded. The performance of the models was assessed using standardized mortality ratios (SMR) of observed versus predicted outcomes for calibration and concordance (c)-statistics for discrimination. Results: SSc-ILD patients with usual interstitial pneumonia (31, 17%) had a higher mortality than those with non-specific interstitial pneumonia (147, 83%) (hazard ratio 2.27; 95%CI 1.03–4.97). All 3 models had comparable discrimination (c = 0.72, 0.72, and 0.71, respectively). Regarding calibration, the ILD-GAP model underestimated mortality (SMR 1.50; 95%CI 1.05–2.14). Calibration was acceptable for SADL (SMR 1.00; 95%CI 0.70–1.44) and GAP (SMR 0.90; 95%CI 0.63–1.29). The SADL model underestimated mortality in Stage I ILD. Conclusions: The ILD-GAP model underestimated mortality, and the SADL model underestimated mortality in certain subgroups. However, the GAP model performed well in this cohort, providing the best prognostic information for SSc-ILD.

AB - Purpose: The gender, age, and lung physiology (GAP) model, interstitial lung diseases—GAP (ILD-GAP) model, and the smoking history, age, and diffusion capacity of the lung (SADL) model were compared using a systemic sclerosis-ILD (SSc-ILD) cohort to evaluate which best determined prognosis. Methods: The models were applied to a cohort of 179 patients with SSc seen at a tertiary care center within 1 year of ILD diagnosis. Demographics, clinical characteristics, and mortality were recorded. The performance of the models was assessed using standardized mortality ratios (SMR) of observed versus predicted outcomes for calibration and concordance (c)-statistics for discrimination. Results: SSc-ILD patients with usual interstitial pneumonia (31, 17%) had a higher mortality than those with non-specific interstitial pneumonia (147, 83%) (hazard ratio 2.27; 95%CI 1.03–4.97). All 3 models had comparable discrimination (c = 0.72, 0.72, and 0.71, respectively). Regarding calibration, the ILD-GAP model underestimated mortality (SMR 1.50; 95%CI 1.05–2.14). Calibration was acceptable for SADL (SMR 1.00; 95%CI 0.70–1.44) and GAP (SMR 0.90; 95%CI 0.63–1.29). The SADL model underestimated mortality in Stage I ILD. Conclusions: The ILD-GAP model underestimated mortality, and the SADL model underestimated mortality in certain subgroups. However, the GAP model performed well in this cohort, providing the best prognostic information for SSc-ILD.

KW - Interstitial lung disease

KW - Mortality modeling

KW - Non-specific interstitial pneumonia

KW - Systemic sclerosis

KW - Usual interstitial pneumonia

UR - http://www.scopus.com/inward/record.url?scp=85047193899&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047193899&partnerID=8YFLogxK

U2 - 10.1007/s00408-018-0126-6

DO - 10.1007/s00408-018-0126-6

M3 - Article

SP - 1

EP - 8

JO - Lung

JF - Lung

SN - 0341-2040

ER -