{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:01:09Z","timestamp":1784761269536,"version":"3.55.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Expiratory central airway collapse (ECAC) is caused by anterior displacement of the posterior membrane (EDAC) or weakening of the cartilaginous walls (TBM). Differentiating the 2 is challenging, resulting in misdiagnosis and missed opportunities for patients. We investigated how accurately providers identify each pathology on computed tomographic (CT) images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Images from 100 patients who underwent tracheobronchoplasty (TBP) were reviewed by 4 airway experts and categorized into TBM, EDAC, normal airway, or unknown by majority consensus. Selected images of patients with TBM (n=9) and EDAC (n=9) were distributed to respondents. Linear regression was used to investigate overall accuracy; inter-rater agreement was measured using Fleiss\u2019 kappa (\u03ba).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We recruited 35 surgeons and 35 pulmonologists. Most practiced at an academic center (68.5%) and cared for patients with ECAC (61.4%). Among surgeons, 14 (40.0%) performed \u22655 complex airway cases yearly, and 13 (37.1%) performed TBP. Only 1 (1.5%) assigned the correct diagnosis to all 18 patients, while 13 (18.6%) identified &lt;50.0% of the correct diagnoses. Inter-rater agreement for respondents was low (\u03ba=0.21; 95% CI: 0.17-0.30;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). Predictors of accuracy included \u226510 years in practice (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      =0.49; 95% CI: 0.03-0.95;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.03) and practicing pulmonology (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      =0.72; 95% CI: 0.15-1.29;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Distinguishing EDAC and TBM is challenging, with poor agreement among clinicians. Therefore, clinicians should consider referring any patient with ECAC early for multidisciplinary evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/lbr.0000000000001069","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:00:58Z","timestamp":1777878058000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Distinguishing Tracheobronchomalacia and Excessive Dynamic Airway Collapse on Dynamic CT Images"],"prefix":"10.1097","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4731-2979","authenticated-orcid":false,"given":"Paolo","family":"de Angelis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Rama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fleming","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir S.","family":"Parikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Majid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Kent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9357-6169","authenticated-orcid":false,"given":"Sidhu P.","family":"Gangadharan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"key":"R1-20260504","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1440-1843.2006.00862.x","article-title":"Tracheobronchomalacia and excessive dynamic airway collapse","volume":"11","author":"Murgu","year":"2006","journal-title":"Respirology"},{"key":"R2-20260504","doi-asserted-by":"crossref","first-page":"E57","DOI":"10.21037\/jtd.2017.01.13","article-title":"Current concepts in severe adult tracheobronchomalacia: evaluation and treatment","volume":"9","author":"Buitrago","year":"2017","journal-title":"J Thorac 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