Related Experiment Video
Updated: Jul 4, 2026
04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
19.9K
Disease Behaviour Classification: A pragmatic model for predicting outcomes in Interstitial Lung Disease
Megan Harrison1, Helen E Jo2, Lauren K Troy2
1Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Respiratory Medicine
|February 14, 2024
Summary
The disease behavior classification (DBC) effectively predicts prognosis in interstitial lung diseases (ILD). This classification tool, determined at ILD multidisciplinary meetings, aids in managing ILD patient care.
Area of Science:
- Pulmonology
- Medical Prognostics
- Clinical Classification
Background:
- Interstitial lung diseases (ILD) present heterogeneously with variable prognoses.
- The disease behavior classification (DBC) categorizes ILD into five classes based on predicted clinical course.
- International guidelines proposed DBC in 2013 to standardize ILD management.
Purpose of the Study:
- To evaluate the prognostic utility of the disease behavior classification (DBC) in a cohort of interstitial lung disease (ILD) patients.
- To assess if DBC can predict clinical outcomes and progression-free survival in ILD.
- To determine the role of DBC in the management of ILD.
Main Methods:
- A cohort of 137 consecutive ILD patients was analyzed.
- Diagnosis and DBC category (1-5) were determined by multidisciplinary meeting (MDM) consensus.
- Clinical and physiological data were collected, and the relationship between DBC and prognostic outcomes was explored over a median follow-up of 3.9 years.
Main Results:
- Increasing DBC class was significantly associated with poorer progression-free survival (PFS) on univariable analysis (HR 1.6, p<0.001).
- DBC remained a significant predictor of PFS in multivariable analysis, independent of age, gender, baseline FVC%, and ILD diagnosis.
- Patients were stratified into DBC categories: DBC2 (12%), DBC3 (7.3%), DBC4 (40%), and DBC5 (41%). DBC1 was not observed.
Conclusions:
- Disease behavior classification (DBC), determined at ILD multidisciplinary meetings, demonstrates significant prognostic utility.
- DBC serves as a valuable tool for predicting outcomes and guiding the management of patients with interstitial lung diseases.
- The findings support the integration of DBC into routine ILD clinical practice.
Related Concept Videos
01:17Classification of Illness
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
01:18Models of Health Promotion and Illness Prevention II
The person's health status fluctuates continually, varying from being in good health to becoming ill and returning to being healthy. To understand the concept of illness prevention, there are two models. First, the health-illness continuum model is a graphic representation of an individual's wellness. It states that a person is considered healthy in the absence of physical disease and the presence of good emotional health.
The agent-host-environment model states that disease results from...
The agent-host-environment model states that disease results from...
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation
Chronic Inflammation
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
01:26Asthma-II: Pathophysiology and Classification
Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...