determinants of health-related quality of life deterioration in interstitial lung disease patients
Bibliographic record
Abstract
Background: Health-related quality of life (HRQL) in patients with interstitial lung disease (ILD) is known to be poor, however, predictors for HRQL decline over time are sparsely investigated. We aimed to identify predictors for HRQL decline in ILD-patients within a 12-month observation period. Methods: We used longitudinal data of 194 ILD patients recruited at two large German ILD centers in the observational HILDA study. We used the generic HRQL measure, EQ-5D Visual Analog Scale (VAS), and the disease-specific Kingʼs Brief Interstitial Lung Disease questionnaire (KBILD) with the subdomains ‘psychological impact’, ‘chest symptomsʼ and ’breathlessness and activitiesʼ. Scores for both measures range between zero (worst HRQL) and 100 (best HRQL). We used the minimal clinically important differences (MCID) of VAS (6.9) and K-BILD (8) to analyze the proportion of patients who experienced a clinically meaningful decline in HRQL. Subsequently we investigated sociodemographic factors, lung function, baseline HRQL and medical history, as potential predictors of HRQL deterioration. Results: Within the study population (34.0% male, Ø age 61.7) mean HRQL scores hardly changed between baseline and 12-months follow up (K-BILD: 52.8 vs. 52.5 | VAS: 60.0 vs. 57.3). On the intra-individual level according to prespecified MCIDs, 35.1% of patients experienced a clinically relevant deterioration in ‘breathlessness and activitiesʼ, 30.7% in ’chest symptomsʼ, 28.4% in ‘psychological impact’, 29.9% in KBILD total score and 29.4% in VAS. Baseline DLCO% pred. was associated with deterioration in ‘breathlessness and activitiesʼ (β-coef.-0.04, p = 0.003) and ’chest symptomsʼ (β-coef. − 0.04, p = 0.002) and baseline FVC% pred. with deterioration in ‘psychological impact’ (β-coef. − 0.02, p = 0.021), KBILD total score (β-coef. − 0.02, p = 0.007) and VAS (β-coef. − 0.04, p < 0.0001). On the contrary, increasing age positively influenced ‘psychological impact’ (β-coef. 0.06, p < 0,0001). Other factors had no significant impact. Conclusion: Around a third of ILD patients experienced a clinically relevant HRQL deterioration in a 12-months period, which is mainly predicted by lung function baseline value. Thus, measures of lung function are important clinical assessment tools to predict the consequences of the disease for everyday life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".