@article {1675206,
	title = {Suspected Interstitial Lung Disease in COPDGene Study},
	journal = {Am J Respir Crit Care Med},
	volume = {207},
	number = {1},
	year = {2023},
	month = {2023 Jan 01},
	pages = {60-68},
	abstract = {Rationale: Although interstitial lung abnormalities (ILA), specific patterns of incidentally-detected abnormal density on computed tomography, have been associated with abnormal lung function and increased mortality, it is unclear if a subset with incidental interstitial lung disease (ILD) accounts for these adverse consequences. Objectives: To define the prevalence and risk factors of suspected ILD and assess outcomes. Methods: Suspected ILD was evaluated in the COPDGene (Chronic Obstructive Pulmonary Disease Genetic Epidemiology) study, defined as ILA and at least one additional criterion: definite fibrosis on computed tomography, FVC less than 80\% predicted, or DLCO less than 70\% predicted. Multivariable linear, longitudinal, and Cox proportional hazards regression models were used to assess associations with St. George{\textquoteright}s Respiratory Questionnaire, 6-minute-walk test, supplemental oxygen use, respiratory exacerbations, and mortality. Measurements and Main Results: Of 4,361 participants with available data, 239 (5\%) had evidence for suspected ILD, whereas 204 (5\%) had ILA without suspected ILD. In multivariable analyses, suspected ILD was associated with increased St. George{\textquoteright}s Respiratory Questionnaire score (mean difference [MD], 3.9 points; 95\% confidence interval [CI], 0.6-7.1; P = 0.02), reduced 6-minute-walk test (MD, -35 m; 95\% CI, -56 m to -13 m; P = 0.002), greater supplemental oxygen use (odds ratio [OR], 2.3; 95\% CI, 1.1-5.1; P = 0.03) and severe respiratory exacerbations (OR, 2.9; 95\% CI, 1.1-7.5; P = 0.03), and higher mortality (hazard ratio, 2.4; 95\% CI, 1.2-4.6; P = 0.01) compared with ILA without suspected ILD. Risk factors associated with suspected ILD included self-identified Black race (OR, 2.0; 95\% CI, 1.1-3.3; P = 0.01) and pack-years smoking history (OR, 1.2; 95\% CI, 1.1-1.3; P = 0.0005). Conclusions: Suspected ILD is present in half of those with ILA in COPDGene and is associated with exercise decrements and increased symptoms, supplemental oxygen use, severe respiratory exacerbations, and mortality.},
	keywords = {Humans, Lung, Lung Diseases, Interstitial, Oxygen, Pulmonary Disease, Chronic Obstructive, Smoking},
	issn = {1535-4970},
	doi = {10.1164/rccm.202203-0550OC},
	author = {Rose, Jonathan A and Menon, Aravind A and Hino, Takuya and Hata, Akinori and Nishino, Mizuki and Lynch, David A and Rosas, Ivan O and El-Chemaly, Souheil and Raby, Benjamin A and Ash, Samuel Y and Choi, Bina and Washko, George R and Silverman, Edwin K and Cho, Michael H and Hatabu, Hiroto and Putman, Rachel K and Hunninghake, Gary M}
}