B41-20 Accuracy of Clinician Suspicion for Pulmonary Hypertension in Interstitial Lung Disease by Care Setting: Interim Comparison From the PHINDER Study

Abstract Background Despite the poor prognosis of interstitial lung disease (ILD) with pulmonary hypertension (PH), there are no evidence-based guidelines for PH screening in ILD. PHINDER (NCT05776225) aims to develop a PH screening methodology in patients with ILD. This interim analysis of the PHINDER study compared the accuracy of study clinicians’ suspicion of PH at comprehensive care centers (CCCs) accredited by the Pulmonary Hypertension Association (PHA) or Pulmonary Fibrosis Foundation (PFF), versus centers not accredited by either organization (non-CCCs). Methods PHINDER is a prospective, multicenter study in which patients with ILD undergo routine non-invasive assessments followed by right heart catheterization (RHC) to confirm pre-capillary PH (mPAP20 mmHg, PVR2 WU, PCWP≤15 mmHg). After reviewing all non-invasive test results but prior to RHC, study clinicians are asked to rank their suspicion of PH as low, medium, or high. Results At the time of this interim analysis (May 2025), 189 patients had likelihood of PH assigned by their clinician prior to RHC; 148 (78%) were treated at a CCC and 41 (22%) were not (Figure 1). At CCCs, 24 patients were deemed low suspicion for PH, of whom 16 (67%) had PH ruled out on RHC, while at non-CCCs, 4 patients were deemed low suspicion, of whom 3 (75%) had PH ruled out. At CCCs, 55 patients were deemed high suspicion for PH, of whom 35 (64%) had PH confirmed on RHC, while at non-CCCs, 19 patients were deemed high suspicion, of whom 16 (84%) had PH confirmed. For patients deemed low or high suspicion, clinicians at CCCs were correct in 65% of cases while clinicians at non-CCCs were correct in 83% of cases. Conclusions A numerically greater discrepancy was seen between clinician suspicion of PH and RHC-confirmed hemodynamics at PHA- or PFF-accredited Care Comprehensive Centers, although the sample size in the non-CCC group and referral bias in the CCC group may limit this conclusion. Despite this, there was still a notable discrepancy seen at both CCCs and non-CCCs, emphasizing the need for more standardized PH screening in patients with ILD, regardless of care setting. This abstract is funded by: United Therapeutics