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Cited by 65Interstitial Lung Diseases and Idiopathic Pulmonary FibrosisOccupational and environmental lung diseasesSystemic Sclerosis and Related Diseases

The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.

The performance of the GAP model in patients with rheumatoid arthritis associated interstitial lung disease

Open access
Morisset, Julie, Vittinghoff, Eric, Lee, Bo Young, Tonelli, Roberto, Hu, Xiaowen, Elicker, Brett M., Ryu, Jay H., Jones, Kirk D., Cerri, Stefania, Manfredi, Andreina, Sebastiani, Marco, Gross, Andrew J., Ley, Brett, Wolters, Paul J., King, Talmadge E., Kim, Dong Soon, Collard, Harold R., Lee, Joyce S.·2017·Respiratory Medicine
DOI 10.1016/j.rmed.2017.04.012PMC PMC5506836
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Abstract

Background Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is associated with significant morbidity and mortality. Similarities have been observed between patients with idiopathic pulmonary fibrosis (IPF) and the UIP (usual interstitial pneumonia) form of RA-ILD. The GAP (gender, age, physiology) model has been shown to predict mortality in patients with IPF, but its ability to predict mortality in RA-ILD is not known.Methods We identified 309 patients with RA-ILD at 4 academic centers with ongoing longitudinal cohorts of patients with ILD. The primary endpoint was mortality. To handle missing data (n = 219 subjects with complete dataset), multiple imputation by iterative chained equations was used. Using the GAP model as a baseline, we assessed improvements in mortality risk prediction achieved by incorporating additional variables. Model discrimination was assessed using the c-index, and calibration was checked by comparing observed and expected incidence of death.Results Patients had a mean age of 65 years and were predominantly female (54%). The mean forced vital capacity (FVC) % predicted was 73 and the mean diffusing capacity for carbon monoxide (DL CO) % predicted was 55. Twenty-four percent of the 236 patients with a high-resolution computed tomography scan available for review had a definite UIP pattern. The original GAP model, including gender, age, FVC%, and DL CO%, had a c-index of 0.746 in our cohort. Calibration of this model was satisfactory at 1, 2 and 3 years. Model discrimination was not meaningfully improved by adding other clinical variables.Conclusion The GAP model that was derived for IPF performs similarly as a mortality risk prediction tool in RA-ILD.

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  • Composite outcome predictors in interstitial lung disease have limited clinical uptake and external validation.

    “Different composite predictors of outcome have been developed in the past years; however, clinical uptake and external validation is limited.(226–232)”

    From Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation. (2021) · cites this paper as [230]

    The Introduction (page unavailable) identifies GAP as a validated mortality predictor in idiopathic pulmonary fibrosis but says its performance in rheumatoid arthritis–associated ILD was not known. That supports a validation gap for this specific population, not the broader claim that composite predictors across ILD have limited external validation. The paper does not address clinical uptake. (LLM, conf=0.79)

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Metadata

Authors
Morisset, J., Vittinghoff, E., Lee, B. Y., Tonelli, R., Hu, X., Elicker, B. M., Ryu, J. H., Jones, K. D., Cerri, S., Manfredi, A., Sebastiani, M., Gross, A. J., Ley, B., Wolters, P. J., King, T. E., Kim, D. S., Collard, H. R., & Lee, J. S.
Affiliations
  • University of California, San Francisco (US)
  • Asan Medical Center (KR)
  • University of Modena and Reggio Emilia (IT)
  • Mayo Clinic (US)
  • University of Colorado Denver (US)
Corresponding author
Morisset, Julie
ORCID
Venue
Respiratory Medicine
Publisher
Elsevier BV
Published
2017-06
Volume
127
Pages
51-56
ISSN
0954-6111 (ISSN-L)
DOI
10.1016/j.rmed.2017.04.012
PMC
PMC5506836
OpenAlex
W2605649105
Cited by
65
References
29
Citations by year
2026: 4 · 2025: 6 · 2024: 8 · 2023: 10 · 2022: 5 · 2021: 11 · 2020: 10 · 2019: 8 · 2018: 1 · 2017: 2
FWCI
4.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Respiratory Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
Funders
  • National Center for Advancing Translational Sciences (UCSF-CTI KL2TR000143)
  • Nina Ireland Program for Lung Health
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
  • Health Sciences › Medicine › Rheumatology › Systemic Sclerosis and Related Diseases
Keywords
rheumatoid arthritis-associated interstitial lung disease, gap model, mortality prediction, usual interstitial pneumonia, idiopathic pulmonary fibrosis, model discrimination, model calibration, forced vital capacity, diffusing capacity for carbon monoxide, high-resolution computed tomography
MeSH terms
Aged, Arthritis, Rheumatoid, Carbon Monoxide, Female, Health Status Indicators, Humans, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Vital Capacity, Incidence, Lung Diseases, Interstitial, Idiopathic Pulmonary Fibrosis

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