Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study

Objectives To evaluate the validity of the rheumatoid arthritis-interstitial lung disease screening project of the Spanish Society of Rheumatology (AR-EPIDSER) screening criteria for detecting rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) and to estimate the prevalence of undi...

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Autores: Mena-Vázquez, N, Domínguez-Alvaro, M, Hernán, MGB, Atienza-Mateo, B, Peña, MFV, Fernández, IP, Ortiz, AM, Park, HS, Gomez, NP, Plasencia-Rodríguez, C, Hurtado, MCA, Pérez, SH, Serrano-Combarro, A, Vegas-Revenga, N, Vidal, JAB, Lacasa-Molina, J, Burger, S, Fernández, CC, Aresté, JF, Ostiz, JAM, Gómez, MDM, Alvaredo, D, Castañeda, S
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:dnet:r-fisabio___::10ed2ec84fc5077fcb0126d589976945
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/21498
Access Level:acceso abierto
Palabra clave:Rheumatoid Arthritis
Prevalence
Lung Diseases, Interstitial
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spelling Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER studyMena-Vázquez, NDomínguez-Alvaro, MHernán, MGBAtienza-Mateo, BPeña, MFVFernández, IPOrtiz, AMPark, HSGomez, NPPlasencia-Rodríguez, CHurtado, MCAPérez, SHSerrano-Combarro, AVegas-Revenga, NVidal, JABLacasa-Molina, JBurger, SFernández, CCAresté, JFOstiz, JAMGómez, MDMAlvaredo, DCastañeda, SRheumatoid ArthritisPrevalenceLung Diseases, InterstitialObjectives To evaluate the validity of the rheumatoid arthritis-interstitial lung disease screening project of the Spanish Society of Rheumatology (AR-EPIDSER) screening criteria for detecting rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) and to estimate the prevalence of undiagnosed and subclinical ILD in patients with RA in Spain.<br /> Patients and methods Multicentre cross-sectional observational study conducted in 15 Spanish hospitals. Adult patients with RA (American College of Rheumatology (ACR) 1987 or ACR/European Alliance of Associations for Rheumatology 2010 criteria) without a previous ILD diagnosis were included. During a rheumatology visit, the AR-EPIDSER screening criteria were applied, and all participants underwent high-resolution CT (HRCT) of the chest as the reference test, with centralised reading. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated with 95% Cl as well as the prevalence of ILD and subclinical ILD.<br /> Results A total of 477 patients were recruited, 424 had evaluable HRCT (73.6% women, median age 59 years). The prevalence of ILD on HRCT examinations was 13.0% (55/424; 95% CI 9.9% to 16.6%). Subclinical ILD (no cough, dyspnoea or 'Velcro-like' crackles) was 8.3% (35/424; 95%CI 5.7% to 11.1%), accounting for 63.6% of ILD cases. Screening was positive in 68.2% (289/424). The AR-EPIDSER criteria showed sensitivity-0.93 (95% CI 0.82 to 0.98), specificity=0.36 (0.31 to 0.41), PPV-0.18 (0.13 to 0.23) and NPV-0.97 (0.93 to 0.99).<br /> Conclusion In Spanish patients with RA, undiagnosed ILD is frequent and mostly subclinical. The AR-EPIDSER criteria are useful as an initial screening tool due to high sensitivity and excellent NPV; however, low specificity suggests that positive cases should be confirmed by HRCT.BMJ PUBLISHING GROUP2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/21498RMD OpenISSN: 20565933reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:dnet:r-fisabio___::10ed2ec84fc5077fcb0126d5899769452026-06-11T12:45:17Z
dc.title.none.fl_str_mv Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
title Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
spellingShingle Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
Mena-Vázquez, N
Rheumatoid Arthritis
Prevalence
Lung Diseases, Interstitial
title_short Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
title_full Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
title_fullStr Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
title_full_unstemmed Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
title_sort Validation of screening criteria for interstitial lung disease in rheumatoid arthritis in routine clinical practice: the VAR-EPIDSER study
dc.creator.none.fl_str_mv Mena-Vázquez, N
Domínguez-Alvaro, M
Hernán, MGB
Atienza-Mateo, B
Peña, MFV
Fernández, IP
Ortiz, AM
Park, HS
Gomez, NP
Plasencia-Rodríguez, C
Hurtado, MCA
Pérez, SH
Serrano-Combarro, A
Vegas-Revenga, N
Vidal, JAB
Lacasa-Molina, J
Burger, S
Fernández, CC
Aresté, JF
Ostiz, JAM
Gómez, MDM
Alvaredo, D
Castañeda, S
author Mena-Vázquez, N
author_facet Mena-Vázquez, N
Domínguez-Alvaro, M
Hernán, MGB
Atienza-Mateo, B
Peña, MFV
Fernández, IP
Ortiz, AM
Park, HS
Gomez, NP
Plasencia-Rodríguez, C
Hurtado, MCA
Pérez, SH
Serrano-Combarro, A
Vegas-Revenga, N
Vidal, JAB
Lacasa-Molina, J
Burger, S
Fernández, CC
Aresté, JF
Ostiz, JAM
Gómez, MDM
Alvaredo, D
Castañeda, S
author_role author
author2 Domínguez-Alvaro, M
Hernán, MGB
Atienza-Mateo, B
Peña, MFV
Fernández, IP
Ortiz, AM
Park, HS
Gomez, NP
Plasencia-Rodríguez, C
Hurtado, MCA
Pérez, SH
Serrano-Combarro, A
Vegas-Revenga, N
Vidal, JAB
Lacasa-Molina, J
Burger, S
Fernández, CC
Aresté, JF
Ostiz, JAM
Gómez, MDM
Alvaredo, D
Castañeda, S
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Rheumatoid Arthritis
Prevalence
Lung Diseases, Interstitial
topic Rheumatoid Arthritis
Prevalence
Lung Diseases, Interstitial
description Objectives To evaluate the validity of the rheumatoid arthritis-interstitial lung disease screening project of the Spanish Society of Rheumatology (AR-EPIDSER) screening criteria for detecting rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) and to estimate the prevalence of undiagnosed and subclinical ILD in patients with RA in Spain.<br /> Patients and methods Multicentre cross-sectional observational study conducted in 15 Spanish hospitals. Adult patients with RA (American College of Rheumatology (ACR) 1987 or ACR/European Alliance of Associations for Rheumatology 2010 criteria) without a previous ILD diagnosis were included. During a rheumatology visit, the AR-EPIDSER screening criteria were applied, and all participants underwent high-resolution CT (HRCT) of the chest as the reference test, with centralised reading. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated with 95% Cl as well as the prevalence of ILD and subclinical ILD.<br /> Results A total of 477 patients were recruited, 424 had evaluable HRCT (73.6% women, median age 59 years). The prevalence of ILD on HRCT examinations was 13.0% (55/424; 95% CI 9.9% to 16.6%). Subclinical ILD (no cough, dyspnoea or 'Velcro-like' crackles) was 8.3% (35/424; 95%CI 5.7% to 11.1%), accounting for 63.6% of ILD cases. Screening was positive in 68.2% (289/424). The AR-EPIDSER criteria showed sensitivity-0.93 (95% CI 0.82 to 0.98), specificity=0.36 (0.31 to 0.41), PPV-0.18 (0.13 to 0.23) and NPV-0.97 (0.93 to 0.99).<br /> Conclusion In Spanish patients with RA, undiagnosed ILD is frequent and mostly subclinical. The AR-EPIDSER criteria are useful as an initial screening tool due to high sensitivity and excellent NPV; however, low specificity suggests that positive cases should be confirmed by HRCT.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/21498
url https://fisabio.portalinvestigacion.com/publicaciones/21498
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMJ PUBLISHING GROUP
publisher.none.fl_str_mv BMJ PUBLISHING GROUP
dc.source.none.fl_str_mv RMD Open
ISSN: 20565933
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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