Abstract Rationale Pulmonary hypertension (PH) is a major complication of interstitial lung disease (ILD) and is associated with increased morbidity and mortality. Early recognition of PH in ILD is crucial for guiding diagnostic evaluation, initiating treatment, and considering lung transplantation. The PH-ILD Detection Tool developed by Parikh et al. incorporated eight clinical, physiologic, and imaging variables to stratify patients into low-, intermediate-, and high-risk groups, and was subsequently validated in an independent cohort with good performance. While effective, the multi-component score may be difficult to implement in routine clinical practice. The aim of this study was to develop a simplified screening tool for PH in ILD that relies on easily obtainable data. Methods We conducted a retrospective cohort study using data from 154 ILD patients who underwent right heart catheterization (RHC) between October 2016 and February 2022. The abbreviated screening tool was derived from three variables within the original eight-variable PH-ILD Detection Tool: (1) physical examination findings suggestive of PH, (2) diffusing capacity for carbon monoxide (DLCO) 40% predicted, and (3) use of supplemental oxygen. Each variable was assigned one point (score range 0-3). Diagnostic performance was evaluated using sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) analysis. Results The overall prevalence of PH in the cohort was 48.1%. The prevalence of PH increased progressively with higher scores: 14.3% for a score of 0, 58.1% for 1, 79.0% for 2, and 87.2% for 3. Using a threshold of ≥ 2, the abbreviated tool demonstrated 90% sensitivity, 58% specificity, 78% positive predictive value (PPV), and 79% negative predictive value (NPV). A threshold of 3 yielded 54% sensitivity, 88% specificity, 87% PPV, and 56% NPV. ROC analysis evaluating the discriminatory ability of the 3-point screening score to identify PH-ILD showed an area under the curve (AUC) of 0.74 (95% CI: 0.65-0.82; p 0.001), indicating statistically significant performance in distinguishing patients with and without PH. Conclusion A simplified 3-point PH-ILD screening tool incorporating physical examination findings, DLCO 40%, and supplemental oxygen use demonstrated meaningful accuracy in detecting PH among ILD patients. This practical tool may support early recognition, prompt referral for confirmatory testing, and improved management of PH-ILD. This abstract is funded by: None
Dagher et al. (Fri,) studied this question.