Reply: The rationale for distinguishing RB-ILD and AMP
Bibliographic record
Abstract
Extract The 2025 European Respiratory Society/American Thoracic Society update on the classification of the interstitial pneumonias provides a comprehensive framework for the subcategorisation of these disorders, with particular focus on the corresponding histological and radiological patterns [1]. This classification includes continued separation of alveolar macrophage pneumonia (AMP), which was formerly termed desquamative interstitial pneumonia (DIP), and respiratory bronchiolitis–interstitial lung disease (RB-ILD). S. Mukhopadhyay and I. Sansano agree with the proposed change in terminology but have questioned the ongoing distinction between AMP and RB-ILD, arguing that these should be considered part of a single “smoking-related ILD” entity, along with inclusion of smoking-related interstitial fibrosis. Their primary rationale is based on the characteristic accumulation of macrophages within the alveolar spaces in all three of these entities and the frequent association of these findings with cigarette smoking [1]. Although S. Mukhopadhyay and I. Sansano raise important points for discussion, the committee was convinced by multiple arguments that RB-ILD and AMP should be kept as two distinct multidisciplinary diagnoses.
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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 | 0.015 | 0.091 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.004 | 0.007 |
| Scholarly communication | 0.005 | 0.008 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.073 | 0.088 |
| Insufficient payload (model declined to judge) | 0.006 | 0.011 |
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".