{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:48:08Z","timestamp":1790851688849,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006630","name":"Lung Foundation Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006630","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2017479"],"award-info":[{"award-number":["2017479"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Interstitial lung diseases (ILDs) lead to breathlessness, cough, deteriorating quality of life and early death. Patients are typically diagnosed late in their disease course when existing lung damage cannot be reversed. Accordingly, early diagnosis is the best strategy for preserving lung function and extending lifespan. Our aim was to identify signs, symptoms and health patterns and determine when they arise in the years preceding ILD diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified incident ILD cases from a large primary care electronic medical record database from the United Kingdom. Prevalence and timing of symptoms, signs and health patterns were compared to matched controls in the 10\u2009years preceding diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ILD patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200918,914) had symptoms of dyspnoea, cough, fatigue, weight loss and loss of appetite recorded more frequently compared to controls (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200960,156). Most patients (73%) reported cough or dyspnoea at least once at a primary care visit, with 13%\u201317% recording symptoms on \u2265\u20095 separate occasions (dyspnoea: 13% cases, 5% controls; cough: 17% cases, 7% controls). ILD patients had a greater cumulative incidence of cough and dyspnoea even 10\u2009years before diagnosis (OR: 1.73 [1.58, 1.89],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with the odds ratio increasing to 2.38 at 1\u2009year before diagnosis. Most ILD patients were initially diagnosed with another respiratory condition (95%\u201397%) or heart failure (4%\u20139%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gradual onset of non\u2010specific symptoms over 10\u2009years, coupled with referrals to other specialities and misdiagnoses, delays ILD diagnosis. Improving awareness of ILD among primary care practitioners may shorten the time to diagnosis and expedite access to treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70230","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:11:11Z","timestamp":1773292271000},"page":"599-609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characterising Patient Pathways Prior to the Diagnosis of Interstitial Lung Disease"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1027-7081","authenticated-orcid":false,"given":"Caitlin C.","family":"Fermoyle","sequence":"first","affiliation":[{"name":"The University of Sydney, Faculty of Medicine and Health  Sydney Australia"},{"name":"Department of Respiratory Medicine and Sleep Royal Prince Alfred Hospital  Sydney 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3103-2665","authenticated-orcid":false,"given":"Francesca","family":"Gonnelli","sequence":"additional","affiliation":[{"name":"Optimum Patient Care  Cambridge UK"},{"name":"Department of Medical Science and Public Health Polytechnic University of Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neva","family":"Eleangovan","sequence":"additional","affiliation":[{"name":"Optimum Patient Care  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursie","family":"Smith","sequence":"additional","affiliation":[{"name":"Optimum Patient Care  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heath","family":"Heatley","sequence":"additional","affiliation":[{"name":"Optimum Patient Care  Cambridge 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