Development and validation of the Hypersensitivity Pneumonitis South Asian Questionnaire for Exposure (HP-SAQE): a novel, qualitative and quantitative tool.
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Singh Sheetu, Sharma Ambika, Pilania Khushboo, Singh Prerna, Sharma Arvind Kumar, Dhooria Sahajal, Hadda Vijay, Gupta Nitesh, Gupta Mansi, Rathnapala Amila, Agarwal Arundhati, Singh Nishtha, Joshi Madhur, Mondal Aniket, Bairwa Jitendra, Layek Avishek, Mohan Sanchit, Goyal Chhaya, Bhattacharyya Parthasarathi, Koul Parvaiz A, Dhar Raja, Sarmah Kripesh Ranjan, Maskey Dipesh, Dosi Ravi, H Jayadevappa Gayathri Devi, Gothi Dipti, Mehta Asmita, Gupta Richa, Neopane Arpana, Arjun Padmanabhan, Singh Alok Kumar, Meitei Soibam Pahal, Samarasekera Bodhika, Dalal Sonia, Madhukar Sujeet, Katiyar Sandeep, Nattusamy Loganathan, Dash Devi Jyoti, Dumra Harjit, Talwar Deepak, Spalgais Sonam, Balasubramanian Viswesvaran, Mohan Murali, Saeed Saima, Rehman Matiur, Chhabra Sunil K, Udwadia Zarir F, Agrawal Aditya, Dutt Naveen, Perera Eshanth, Nath Alok, Kumar Rohit, Singh Virendra, Johannson Kerri A
Аннотация
METHODS: A systematic literature search was completed to identify exposures associated with more than five documented hypersensitivity pneumonitis (HP) cases. These exposures were evaluated through a two-round Delphi survey involving 39 pulmonologists from India, Sri Lanka, Pakistan and Nepal. The questionnaire was prospectively derived at one centre and validated across five centres in India and Sri Lanka. The HP South Asian Questionnaire for Exposure (HP-SAQE) was validated against the gold standard multidisciplinary discussion diagnosis, distinguishing HP from non-HP ILD.
RESULTS: The literature search screened 5170 records and included 407 studies, identifying 24 exposures. A 50-item Delphi survey achieved expert consensus (>70%) on 17 qualitative and 4 quantitative items (six questions) by 39 pulmonologists. HP-SAQE score ranged from 0 to 14. After pilot testing, the questionnaire was translated into Hindi, Tamil and Sinhala. In the derivation cohort (n=40), the HP-SAQE score was significantly higher in patients with HP versus non-HP (mean: 10.2±1.6 vs 6.7±4.2; p=0.001). This finding was validated in a separate cohort (n=163; mean: 9.4±2.2 vs 4.13±4.28; p<0.001). Receiver operating characteristic curve analysis showed good diagnostic performance (area under the receiver operating characteristic curve, AUC: 0.791 derivation; 0.858 validation, centre-wise AUCs 0.705-0.967).
CONCLUSION: The HP-SAQE is the first qualitative and quantitative exposure assessment tool for patients with ILD that has a good diagnostic performance.