Table 2.
Key findings | Goal | Missing information | Action items |
Interstitial lung abnormalities (a diverse set of chest CT imaging findings suggestive of an underlying interstitial lung disease) are relatively common in older adults and are associated with adverse outcomes. | To develop radiological standards on reporting interstitial abnormalities. | Do specific imaging findings help predict progression and adverse outcomes in those with interstitial abnormalities? | Studies should focus on trying to identify if specific radiological features and patterns help predict adverse outcomes in those with interstitial abnormalities. |
Studies of physiological and histopathological data suggest that some people with interstitial abnormalities have an early stage of pulmonary fibrosis. | To develop consensus statements on when an imaging abnormality constitutes a disease in an undiagnosed and asymptomatic person. | Can consensus on updated disease definitions be achieved? | Committees should be developed so that evidence-based consensus guidelines and position statements from major societies could be generated and updated when appropriate. |
Some groups appear to be at an increased risk to develop interstitial abnormalities. | To develop effective screening programmes in high-risk groups. | What are the results of early pulmonary fibrosis screening studies? What groups are interested in participating in these types of studies? | In addition to encouraging publication from studies actively participating in screening efforts, funding agencies should consider encouraging these efforts so that populations for secondary prevention trials can be developed. |
Antifibrotic therapy slows lung function decline in patients with IPF, even among those more preserved measures of pulmonary function. | To conduct secondary prevention trials in patients with early stages of pulmonary fibrosis. | What groups with interstitial abnormalities would benefit the most from early therapeutic intervention? Are there secondary endpoints that help predict longer term outcomes in those with interstitial abnormalities? | Early discussions should be undertaken to consider how to define reasonable endpoints and how to appropriately power trials in those with early stages of pulmonary fibrosis. |
IPF, idiopathic pulmonary fibrosis.