Table 5.
Performance of algorithms with exclusion of other causes of interstitial lung disease (Stage IV)
| Algorithm | Description | Sensitivity | Specificity | PPV | NPV | %Agreement | Kappa |
|---|---|---|---|---|---|---|---|
| Stringent ILD definition | |||||||
| 4A | ≥1 pulmonologist ILD diagnosis and exclusion other ILDa | 60.4 (49.2, 70.7) | 98.7 (97.9, 99.2) | 81.1 (70.8, 88.4) | 96.4 (94.4, 97.7) | 95.4 | 0.67 (0.57, 0.75) |
| 4C | CT 7-180 days prior to ILD diagnosis and exclusion other ILDa | 69.7 (56.5, 80.4) | 97.9 (97.0, 98.6) | 76.0 (65.9, 83.8) | 97.2 (95.1, 98.4) | 95.5 | 0.70 (0.60, 0.79) |
| 4D | PFT 7-180 days prior to ILD diagnosis and exclusion other ILDa | 71.7 (59.6, 81.4) | 98.2 (97.7, 98.6) | 78.8 (72.7, 83.8) | 97.4 (95.6, 98.5) | 96.0 | 0.73 (0.65, 0.80) |
| 4G | ≥1 pulmonologist diagnosis and CT or lung biopsy or PFTs 7-180 days prior to ILD diagnosis and exclusion other ILDa | 59.8 (48.7, 70.0) | 98.8 (98.1, 99.2) | 81.9 (72.2, 88.7) | 96.4 (94.4, 97.7) | 95.5 | 0.67 (0.57, 0.75) |
| 4H | CT and PFTs or lung biopsy 7-180 days prior to ILD diagnosis and exclusion other ILDa | 66.9 (54.9, 77.1) | 98.7 (98.2, 99.0) | 82.9 (76.9, 87.6) | 96.9 (94.8, 98.1) | 95.9 | 0.72 (0.63, 0.79) |
| 4I | Pulmonologist diagnosis or CT and PFTs or lung biopsy 7-180 days prior to ILD diagnosis and exclusion other ILDa | 73.2 (60.3, 83.0) | 98.2 (97.4, 98.7) | 78.5 (70.1, 85.1) | 97.6 (95.7, 98.6) | 96.1 | 0.74 (0.65, 0.81) |
| Relaxed ILD definition | |||||||
| 4A | ≥1 pulmonologist ILD diagnosis and exclusion other ILDa | 52.8 (42.9, 62.4) | 98.8 (98.0, 99.3) | 82.9 (72.6, 90.0) | 95.0 (92.7, 96.6) | 94.2 | 0.62 (0.52, 0.70) |
| 4C | CT 7-180 days prior to ILD diagnosis and exclusion other ILDa | 63.0 (51.1, 73.6) | 98.3 (97.3, 98.9) | 80.3 (70.1, 87.6) | 96.0 (93.5, 97.5) | 94.7 | 0.68 (0.58, 0.77) |
| 4D | PFT 7-180 days prior to ILD diagnosis and exclusion other ILDa | 65.4 (53.9, 75.4) | 98.7 (98.2, 99.0) | 84.2 (78.6, 88.6) | 96.3 (94.1, 97.7) | 95.4 | 0.71 (0.62, 0.79) |
| 4G | ≥1 pulmonologist diagnosis and CT or lung biopsy or PFTs 7-180 days prior to ILD diagnosis and exclusion other ILDa | 52.2 (42.5, 61.7) | 98.9 (98.2, 99.3) | 83.7 (74.1, 90.3) | 95.0 (92.7, 96.6) | 94.3 | 0.61 (0.52, 0.70) |
| 4H | CT and PFTs or lung biopsy 7-180 days prior to ILD diagnosis and exclusion other ILDa | 60.0 (49.2, 70.0) | 98.9 (98.5, 99.3) | 86.6 (81.0, 90.8) | 95.6 (93.2, 97.2) | 95.0 | 0.68 (0.59, 0.76) |
| 4I | Pulmonologist diagnosis or CT and PFTs or lung biopsy 7-180 days prior to ILD diagnosis and exclusion other ILDa | 65.4 (53.6, 75.5) | 98.5 (97.7, 99.0) | 82.4 (74.0, 88.5) | 96.3 (94.1, 97.7) | 95.2 | 0.70 (0.61, 0.78) |
a
exclusion of other ILD using diagnostic codes for pneumoconioses, radiation, hypersensitivity pneumonitis, other connective tissue diseases on or after the last ILD diagnosis code date (see Table S3)
Abbreviations: PPV, positive predictive value; NPV, negative predictive value; ILD, interstitial lung disease; CT, computed tomography; PFT, pulmonary function test