Traversi Letizia, Miravitlles Marc, Martinez-Garcia Miguel Angel, Shteinberg Michal, Bossios Apostolos, Dimakou Katerina, Jacob Joseph, Hurst John R, Paggiaro Pier Luigi, Ferri Sebastian, Hillas Georgios, Vogel-Claussen Jens, Dettmer Sabine, Aliberti Stefano, Chalmers James D, Polverino Eva
Dept of Medicine and Surgery, Respiratory Diseases, Università dell'Insubria, Varese-Como, Italy.
Pneumology Dept, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Barcelona, Spain.
ERJ Open Res. 2021 Nov 22;7(4). doi: 10.1183/23120541.00399-2021. eCollection 2021 Oct.
The coexistence of COPD and bronchiectasis seems to be common and associated with a worse prognosis than for either disease individually. However, no definition of this association exists to guide researchers and clinicians.
We conducted a Delphi survey involving expert pulmonologists and radiologists from Europe, Turkey and Israel in order to define the "COPD- [bronchiectasis] BE association".A panel of 16 experts from EMBARC selected 35 statements for the survey after reviewing scientific literature. Invited participants, selected on the basis of expertise, geographical and sex distribution, were asked to express agreement on the statements. Consensus was defined as a score of ≥6 points (scale 0 to 9) in ≥70% of answers across two scoring rounds.
102 (72.3%) out of 141 invited experts participated in the first round. Their response rate in the second round was 81%. The final consensus definition of "COPD-BE association" was: "The coexistence of (1) specific radiological findings ( in ≥1 pulmonary segment and in >1 lobe) with (2) an obstructive pattern on spirometry ([forced expiratory volume in 1 s] FEV/[forced vital capacity] FVC <0.7), (3) at least two characteristic symptoms () and (4) current or past exposure to smoke ≥) or other toxic agents (bi)". These criteria form the acronym "ROSE" (Radiology, Obstruction, Symptoms, Exposure).
The Delphi process formulated a European consensus definition of "COPD-BE association". We hope this definition will have broad applicability across clinical practice and research in the future.
慢性阻塞性肺疾病（COPD）与支气管扩张并存似乎很常见，且与单独任何一种疾病相比，其预后更差。然而，目前尚无关于这种关联的定义来指导研究人员和临床医生。
我们开展了一项德尔菲调查，涉及来自欧洲、土耳其和以色列的肺病专家和放射科医生，以定义“COPD - [支气管扩张] BE关联”。EMBARC的一个由16名专家组成的小组在查阅科学文献后，为该调查挑选了35条陈述。根据专业知识、地域和性别分布挑选出的受邀参与者被要求对这些陈述表达意见。两轮评分中，在≥70%的答案中得分≥6分（0至9分制）被定义为达成共识。
141名受邀专家中有102名（72.3%）参与了第一轮调查。他们在第二轮的回复率为81%。“COPD - BE关联”的最终共识定义为：“（1）特定的放射学表现（≥1个肺段且>1个肺叶）与（2）肺功能检查中的阻塞性模式（1秒用力呼气容积（FEV）/用力肺活量（FVC）<0.7）、（3）至少两种特征性症状（）以及（4）当前或过去接触烟雾≥或其他有毒物质（bi）同时存在”。这些标准构成首字母缩写词“ROSE”（放射学、阻塞、症状、暴露）。
德尔菲法制定了“COPD - BE关联”的欧洲共识定义。我们希望这个定义在未来的临床实践和研究中具有广泛的适用性。
