Yonsei Med J.  2017 Mar;58(2):355-361. 10.3349/ymj.2017.58.2.355.

Prediction of Anthracofibrosis Based on Clinico-Radiographic Findings

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 2Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. kimdkmd@gmail.com
  • 4Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

Abstract

PURPOSE
Because anthracofibrosis (AF) is associated with tuberculosis (TB), detection of AF is clinically relevant in Korea, a TB endemic region. We thus sought to develop and validate a predictive model for AF using clinical radiographic data.
MATERIALS AND METHODS
Between January 1, 2008 and March 31, 2014, 3849 adult patients who underwent bronchoscopies were retrospectively included from an observational registry. We dichotomized patients based on the presence (n=167) or absence (n=242) of AF. After analyzing their clinico-radiographic characteristics, a logistic prediction model was developed. An area under the curve (AUC) was drawn using the weighted score in logistic regression model. To evaluate the degree of overfitting of the predictive model, a 5-fold cross-validation procedure was performed.
RESULTS
In multivariate logistic regression, clinical findings such as age >70 years, female gender, active TB, and computed tomography findings including atelectasis, stenosis, bronchial wall thickening, enlarged and calcified lymph nodes were significant diagnostic predictors for AF. The weighed score had an AUC of 0.939 [95% confidence interval (CI)=0.911-0.960], similar to the AUC obtained from internal validation (AUC=0.926, 95% CI=0.896-0.949).
CONCLUSION
The prediction model may be helpful for predicting AF based only on clinical and radiographic findings. However, further external validation is necessary.

Keyword

Anthracofibrosis; tuberculosis; airway disease; computed tomography; bronchoscopy

MeSH Terms

Aged
Area Under Curve
Bronchi/*diagnostic imaging/pathology
Bronchoscopy
Constriction, Pathologic/*diagnostic imaging
Female
Humans
Logistic Models
Lymph Nodes/*diagnostic imaging/pathology
Male
Middle Aged
Predictive Value of Tests
Radiography
Republic of Korea
Retrospective Studies
Tomography, X-Ray Computed
Tuberculosis, Pulmonary/diagnostic imaging
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