{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:33:19Z","timestamp":1786120399023,"version":"build-2736575974"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0506200"],"award-info":[{"award-number":["2023ZD0506200"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0506204"],"award-info":[{"award-number":["2023ZD0506204"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2024ZD0540900"],"award-info":[{"award-number":["2024ZD0540900"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82570144"],"award-info":[{"award-number":["82570144"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Invasive pulmonary aspergillosis (IPA) is a life-threatening infection with high mortality, often misdiagnosed due to non-specific symptoms. The lack of effective early prediction models delays treatment and worsens outcomes. To identify independent IPA risk factors and develop a clinically actionable nomogram for early prediction, we conducted a nested case-control study within a 10-year cohort of 27\u2009100 pulmonary infection patients. The cohort was split into training (70%) and testing (30%) sets. In the training set, 1002 IPA cases (proven or probable, as defined by European Organization for Research and Treatment of Cancer and Mycosis Research Group Education and Research Consortium 2020 criteria) were included, alongside 2004 randomly selected pneumonia controls (1:2 ratio). A nomogram was developed using multivariable logistic regression in the training set and was evaluated by held-out internal validation in the testing set. Model performance was primarily assessed via area under the curve (AUC), calibration, and decision curve analysis (DCA). Nine independent IPA predictors were identified: bronchiectasis (odds ratio [OR]= 7.07), pulmonary tuberculosis (OR = 2.20), diabetes (OR = 2.09), positive serum galactomannan (GM) test (OR = 1.76), mechanical ventilation (OR = 1.74), connective tissue disease (OR = 1.73), positive serum (1,3)-\u03b2-d-glucan (G) test (OR = 1.48), sputum (OR = 1.33), and neutrophil-to-lymphocyte ratio (OR = 1.01). The nomogram demonstrated moderate stable discrimination (training AUC: 0.73; testing AUC: 0.75), with excellent calibration (Brier scores: 0.183 and 0.110). DCA confirmed clinical utility across wide risk thresholds. In conclusion, this novel nine-variable nomogram using routine clinical data provides a practical tool for early IPA risk estimation, potentially guiding timely decisions and improving outcomes. External validation is warranted.<\/jats:p>","DOI":"10.1093\/mmy\/myag078","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:49:24Z","timestamp":1785498564000},"source":"Crossref","is-referenced-by-count":0,"title":["A clinically actionable nomogram for predicting invasive pulmonary aspergillosis: A nested case-control study"],"prefix":"10.1093","volume":"64","author":[{"given":"Lunfang","family":"Tan","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaorui","family":"Zhou","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Luo","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Zhujiang Hospital, Southern Medical University Department of Pulmonary and Critical Care Medicine, , Guangzhou 510280 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengtu","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanyao","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronger","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinping","family":"Zheng","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Ye","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8101-0192","authenticated-orcid":false,"given":"Yun","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"issue":"16","key":"2026080617070040300_bib1","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1056\/NEJMra2027424","article-title":"Aspergillus infections","volume":"385","author":"Thompson","year":"2021","journal-title":"N Engl J Med."},{"key":"2026080617070040300_bib2"},{"issue":"1","key":"2026080617070040300_bib3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jiph.2019.08.007","article-title":"Recent trends in the epidemiology, diagnosis, treatment, and mechanisms of resistance in clinical Aspergillus species: a general review with a special focus on the Middle Eastern and North African region","volume":"13","author":"Zakaria","year":"2020","journal-title":"J Infect Public Health"},{"issue":"1","key":"2026080617070040300_bib4","doi-asserted-by":"publisher","first-page":"ofw268","DOI":"10.1093\/ofid\/ofw268","article-title":"Trends in hospitalizations related to invasive aspergillosis and mucormycosis in the United States, 2000\u20132013","volume":"4","author":"Vallabhaneni","year":"2017","journal-title":"Open Forum Infect Dis"},{"issue":"3","key":"2026080617070040300_bib5","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1086\/318483","article-title":"Aspergillosis case-fatality rate: systematic review of the literature","volume":"32","author":"Lin","year":"2001","journal-title":"Clin Infect Dis"},{"issue":"6","key":"2026080617070040300_bib6","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1159\/000196477","article-title":"Pulmonary aspergillosis: early diagnosis improves survival","volume":"62","author":"von\u00a0Eiff","year":"1995","journal-title":"Respiration"},{"key":"2026080617070040300_bib7","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.3389\/fmicb.2018.01810","article-title":"Recent advances in diagnosing chronic pulmonary aspergillosis","volume":"9","author":"Takazono","year":"2018","journal-title":"Front Microbiol"},{"issue":"7","key":"2026080617070040300_bib8","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1111\/j.1469-0691.2009.03015.x","article-title":"Pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: incidence, risk factors, and outcome","volume":"16","author":"Guinea","year":"2010","journal-title":"Clin Microbiol Infect"},{"key":"2026080617070040300_bib9","doi-asserted-by":"publisher","first-page":"3247","DOI":"10.2147\/jir.S460702","article-title":"Prevalence, risk factors, and mortality of invasive pulmonary aspergillosis in patients with anti-MDA5+ dermatomyositis: a retrospective study in China","volume":"17","author":"Chen","year":"2024","journal-title":"J Inflamm Res"},{"issue":"8","key":"2026080617070040300_bib10","doi-asserted-by":"publisher","first-page":"myad074","DOI":"10.1093\/mmy\/myad074","article-title":"Invasive pulmonary aspergillosis real-world outcomes: clinical features and risk factors associated with increased mortality","volume":"61","author":"Henao-Mart\u00ednez","year":"2023","journal-title":"Med Mycol"},{"issue":"11","key":"2026080617070040300_bib11","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1097\/cm9.0000000000002354","article-title":"Clinical features and risk factors for viral pneumonia complicated with invasive pulmonary aspergillosis in adult patients","volume":"136","author":"Li","year":"2023","journal-title":"Chin Med J (Engl)"},{"issue":"2","key":"2026080617070040300_bib12","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1111\/myc.13540","article-title":"Prototype early diagnostic model for invasive pulmonary aspergillosis based on deep learning and big data training","volume":"66","author":"Wang","year":"2023","journal-title":"Mycoses"},{"issue":"6","key":"2026080617070040300_bib13","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium","volume":"71","author":"Donnelly","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"1","key":"2026080617070040300_bib14","doi-asserted-by":"publisher","first-page":"20364","DOI":"10.1038\/s41598-024-71455-7","article-title":"Investigation of risk factors for invasive pulmonary aspergillosis among patients with COVID-19","volume":"14","author":"Song","year":"2024","journal-title":"Sci Rep"},{"key":"2026080617070040300_bib15","doi-asserted-by":"publisher","first-page":"441","DOI":"10.2147\/idr.S493019","article-title":"A predictive model for pulmonary aspergillosis in ICU patients: a multicenter retrospective cohort study","volume":"18","author":"Li","year":"2025","journal-title":"Infect Drug Resist"},{"issue":"1","key":"2026080617070040300_bib16","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1186\/s12879-023-08376-9","article-title":"Comparison of endotracheal aspirate and bronchoalveolar lavage fluid metagenomic next-generation sequencing in severe pneumonia: a nested, matched case-control study","volume":"23","author":"Bao","year":"2023","journal-title":"BMC Infect Dis"},{"issue":"5 Spec Iss","key":"2026080617070040300_bib17","doi-asserted-by":"publisher","first-page":"296","DOI":"10.4172\/clinical-practice.1000125","article-title":"Weight loss and diabetes are new risk factors for the development of invasive aspergillosis infection in non-immunocompromized humans","volume":"14","author":"Ghanaat","year":"2017","journal-title":"Clin Pract (Lond)"},{"issue":"11","key":"2026080617070040300_bib18","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1007\/s00134-003-1778-z","article-title":"Immunoparalysis as a cause for invasive aspergillosis?","volume":"29","author":"Hartemink","year":"2003","journal-title":"Intensive Care Med."},{"issue":"3","key":"2026080617070040300_bib19","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1097\/00024382-199903000-00001","article-title":"The effects of injury on the adaptive immune response","volume":"11","author":"Lederer","year":"1999","journal-title":"Shock"},{"issue":"1","key":"2026080617070040300_bib20","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1097\/moh.0000000000000104","article-title":"Hyper-IgE syndromes: recent advances in pathogenesis, diagnostics and clinical care","volume":"22","author":"Farmand","year":"2015","journal-title":"Curr. Opin. Hematol."},{"issue":"1","key":"2026080617070040300_bib21","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.mycmed.2011.12.079","article-title":"Fungal infection and increased mortality in patients with chronic granulomatous disease","volume":"22","author":"Bassiri-Jahromi","year":"2012","journal-title":"J Mycol Med"},{"key":"2026080617070040300_bib22","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/978-1-4614-4726-9_3","article-title":"Invasive fungal infections in patients with chronic granulomatous disease","volume":"764","author":"Henriet","year":"2013","journal-title":"Adv Exp Med Biol"},{"issue":"6","key":"2026080617070040300_bib23","doi-asserted-by":"publisher","first-page":"683","DOI":"10.4314\/ejhs.v28i6.2","article-title":"Tuberculosis status and coinfection of pulmonary fungal infections in patients referred to Reference Laboratory of Health Centers Ghaemshahr City during 2007\u20132017","volume":"28","author":"Amiri","year":"2018","journal-title":"Ethiop J Health Sci"},{"issue":"5","key":"2026080617070040300_bib24","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1128\/cvi.00479-06","article-title":"Histoplasmosis-associated cross-reactivity in the BioRad Platelia Aspergillus enzyme immunoassay","volume":"14","author":"Wheat","year":"2007","journal-title":"Clin Vaccine Immunol"},{"issue":"2","key":"2026080617070040300_bib25","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1128\/jcm.42.2.665-669.2004","article-title":"Association of presence of Aspergillus antibodies with hemoptysis in patients with old tuberculosis or bronchiectasis but no radiologically visible mycetoma","volume":"42","author":"Chu","year":"2004","journal-title":"J Clin Microbiol"},{"issue":"9","key":"2026080617070040300_bib26","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1007\/s10096-015-2409-7","article-title":"Prevalence of chronic pulmonary aspergillosis in patients with tuberculosis from Iran","volume":"34","author":"Hedayati","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"Suppl 1","key":"2026080617070040300_bib27","doi-asserted-by":"publisher","first-page":"S179","DOI":"10.1016\/j.ijmyco.2016.08.010","article-title":"Invasive forms of Candida and Aspergillus in sputum samples of pulmonary tuberculosis patients attending the tuberculosis reference laboratory in Ghaemshahr, Northern Iran: an analysis of samples collected during the past 10years","volume":"5","author":"Jabbari\u00a0Amiri","year":"2016","journal-title":"Int J Mycobacteriol"},{"issue":"3","key":"2026080617070040300_bib28","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/S0255-0857(21)03246-1","article-title":"Mycological and serological study of pulmonary aspergillosis in central India","volume":"20","author":"Kurhade","year":"2002","journal-title":"Indian J Med Microbiol"},{"issue":"3","key":"2026080617070040300_bib29","doi-asserted-by":"publisher","first-page":"22","DOI":"10.7860\/jcdr\/2014\/7957.4094","article-title":"Prevalence of invasive aspergillosis among (PTB) patients in Kanchipuram, India","volume":"8","author":"Sivasankari","year":"2014","journal-title":"J Clin Diagn Res"},{"issue":"5","key":"2026080617070040300_bib30","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s00296-010-1438-x","article-title":"Invasive aspergillosis related with azathioprine-induced leucopenia without mutant allele of thioprine methyltransferase in a patient with rheumatoid arthritis","volume":"31","author":"Jung","year":"2011","journal-title":"Rheumatol Int"},{"issue":"10","key":"2026080617070040300_bib31","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1086\/503427","article-title":"Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis","volume":"42","author":"Pfeiffer","year":"2006","journal-title":"Clin Infect Dis"},{"issue":"3","key":"2026080617070040300_bib32","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1128\/cmr.00091-13","article-title":"Molecular and nonmolecular diagnostic methods for invasive fungal infections","volume":"27","author":"Arvanitis","year":"2014","journal-title":"Clin Microbiol Rev"},{"issue":"1","key":"2026080617070040300_bib33","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1128\/jcm.43.1.299-305.2005","article-title":"Contribution of (1\u21923)-beta-D-glucan chromogenic assay to diagnosis and therapeutic monitoring of invasive aspergillosis in neutropenic adult patients: a comparison with serial screening for circulating galactomannan","volume":"43","author":"Pazos","year":"2005","journal-title":"J Clin Microbiol"},{"issue":"Pt A","key":"2026080617070040300_bib34","doi-asserted-by":"publisher","first-page":"107065","DOI":"10.1016\/j.intimp.2020.107065","article-title":"Novel serological biomarkers for inflammation in predicting disease severity in patients with COVID-19","volume":"89","author":"Xue","year":"2020","journal-title":"Int Immunopharmacol"},{"key":"2026080617070040300_bib35","doi-asserted-by":"publisher","first-page":"9823","DOI":"10.2147\/jir.S499008","article-title":"Development of a prognostic nomogram for nonneutropenic invasive pulmonary aspergillosis based on machine learning","volume":"17","author":"Du","year":"2024","journal-title":"J Inflamm Res"},{"issue":"7","key":"2026080617070040300_bib36","doi-asserted-by":"publisher","first-page":"e13985","DOI":"10.1111\/eci.13985","article-title":"A score for predicting invasive pulmonary aspergillosis in immunocompetent critically ill patients","volume":"53","author":"Li","year":"2023","journal-title":"Eur J Clin Invest"},{"issue":"1","key":"2026080617070040300_bib37","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1186\/s12879-024-09109-2","article-title":"Age difference of patients with and without invasive aspergillosis: a systematic review and meta-analysis","volume":"24","author":"Shekhova","year":"2024","journal-title":"BMC Infect Dis"}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myag078\/70411821\/myag078.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/64\/8\/myag078\/70411821\/myag078.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/64\/8\/myag078\/70411821\/myag078.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T21:07:11Z","timestamp":1786050431000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/doi\/10.1093\/mmy\/myag078\/8748411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,5]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myag078","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"value":"1369-3786","type":"print"},{"value":"1460-2709","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,31]]},"article-number":"myag078"}}