Respiratory Bronchiolitis/Interstitial Lung Disease: Fibrosis, Pulmonary Function, and Evolving Concepts
Bibliographic record
Abstract
CONTEXT: The concept of respiratory bronchiolitis/interstitial lung disease (RBILD) was introduced to explain the presence of interstitial lung disease in individuals whose only finding on surgical lung biopsy was smoker's respiratory bronchiolitis (RB). Over time, the diagnostic criteria for RBILD have become progressively more confused. OBJECTIVE: To review the diagnostic criteria for RBILD. DESIGN: The review was based on the literature and personal experience. CONCLUSIONS: The concept of RBILD has changed over time with the recognition that, histologically and radiologically, RB and RBILD are usually indistinguishable. Most authors accept mild alveolar wall fibrosis extending away from the respiratory bronchioles as a part of both RB and RBILD, and occasional cases show quite marked, but probably localized, interstitial fibrosis. What has not been appreciated is that RB is not only an extremely common disease in cigarette smokers but also is ordinarily associated with airflow obstruction. Further, interstitial fibrosis is sometimes found in centrilobular emphysema, and this phenomenon has probably lead to some cases of centrilobular emphysema being misclassified as RB or RBILD. Despite the presence of fibrosis, centrilobular emphysema is still associated with airflow obstruction. We suggest that RBILD be restricted to the clinical setting in which cigarette smokers have a restrictive or mixed obstructive and restrictive functional abnormality, have a marked decrease in diffusing capacity with minimal evidence of airflow obstruction, or have imaging studies showing ground glass opacities/centrilobular nodules plus reticulation and no other lesion besides RB on biopsy to account for these changes. In this setting, the presence of RB-associated interstitial fibrosis probably causes the functional changes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.003 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".