{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:23:50Z","timestamp":1787009030355,"version":"build-2736575974"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"vor","delay-in-days":52,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pulmonary aspergillosis (CPA) can complicate underlying pulmonary diseases, and clinical management of CPA is challenging. Guidelines support clinicians but due to the complexity of the disease they can be difficult to adhere to.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To map current guideline recommendations for the clinical management of CPA into a scoring tool to facilitate and quantify guideline adherence in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Recommendations for diagnosis, treatment and follow-up of CPA presented in the current ESCMID\/ERS\/ECMM and CPAnet guidance documents were assembled and weighed on the basis of their strength of recommendation and level of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-seven recommendations were identified, resulting in a total maximum EQUAL CPA Score of 51. For diagnostics (ScoreMax\u200a=\u200a27), a strong emphasis on expert consultation, culture, direct microscopy, histopathology, serology and imaging was reflected in respective points, whereas molecular techniques and susceptibility testing count into the diagnostics score to a lesser extent.<\/jats:p>\n                    <jats:p>Ten treatment recommendations (ScoreMax\u200a=\u200a14), including antifungal therapy, therapeutic drug monitoring and treatment duration, were identified. Surgery, where indicated, adds three points. For refractory disease or intolerance of first-line antifungal treatment, optimal second-line treatment added another two points.<\/jats:p>\n                    <jats:p>During follow-up (ScoreMax\u200a=\u200a10), response assessment via imaging gave three points, while culture and serology added two points each to the ScoreMax.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The EQUAL CPA Score intents to be used as a comprehensive tool for measuring guideline adherence. If adherence to current guidelines is associated with clinical outcome, this will be assessed in future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkac378","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T17:08:22Z","timestamp":1666199302000},"page":"225-231","source":"Crossref","is-referenced-by-count":20,"title":["EQUAL CPA Score 2022: a tool to measure guideline adherence for chronic pulmonary aspergillosis"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2457-6437","authenticated-orcid":false,"given":"Rosanne","family":"Sprute","sequence":"first","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, University of Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) , Cologne , Germany"},{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, 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Postgraduate Institute of Medical Education and Research , Chandigarh , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4128-4014","authenticated-orcid":false,"given":"Jesper R","family":"Davidsen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Pulmonary Aspergillosis Center Denmark (PACD), Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research, Odense Respiratory Research Unit (ODIN), University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-9906","authenticated-orcid":false,"given":"Christian B","family":"Laursen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Pulmonary Aspergillosis Center Denmark (PACD), Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research, Odense Respiratory Research Unit (ODIN), University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A","family":"Cornely","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, University of Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) , Cologne , Germany"},{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM) , Cologne , Germany"},{"name":"German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne , Cologne , Germany"},{"name":"Faculty of Medicine and University Hospital Cologne, University of Cologne, Clinical Trials Centre Cologne (ZKS K\u00f6ln) , 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