Clinical care in interstitial lung disease: a critical appraisal of clinical guidance documents
Bibliographic record
Abstract
INTRODUCTION: Interstitial lung diseases (ILDs) are complex, requiring multifaceted care for optimal management of patients' symptoms and health outcomes. This systematic review evaluated the content coverage of currently available clinical guidance documents ILD. METHODS: A systematic search was performed to identify clinical guidance documents published between 2011 and March 2025 in the Embase, Ovid Medline and Trip databases. Document characteristics, quality and contents covered were independently assessed by two reviewers. RESULTS: A total of 79 ILD clinical guidance documents were identified, with clinical practice guidelines (n=50) having superior quality based on the Institute of Medicine standards. The content of most documents (84%) focused on ILD aetiology, with connective tissue disease (44%) being the most discussed. Only 46% of documents covered pulmonary manifestations, which often encompassed pulmonary hypertension (30%) and hypoxaemia (28%). Extrapulmonary morbidities were covered in 28% of documents, with gastro-oesophageal reflux disease (23%) and obstructive sleep apnoea (10%) being commonly presented. Behavioural and lifestyle factors were covered in 34% of documents, with most addressing physical inactivity (30%). Additionally, 51% of documents covered overall diagnostic approach for ILD, 35% lung transplantation, 22% acute exacerbations and 19% palliative care. CONCLUSION: Despite growing awareness of ILD, most clinical guidance documents have limited coverage for domains of patient care outside of diagnosis and pharmacotherapies. Future clinical guidance documents on ILD should address the content gaps to deliver comprehensive care for patients with ILD, with engagement of different stakeholders from various regions.
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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 | 0.103 | 0.425 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.042 | 0.029 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.008 | 0.007 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".