{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:48:07Z","timestamp":1787888887312,"version":"build-2784847793"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":1086,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The definition of acute respiratory distress syndrome (ARDS) has a somewhat controversial history, with some even questioning the need for the term \u201cARDS.\u201d This controversy has been amplified by the coronavirus disease (COVID-19) pandemic given the marked increase in the incidence of ARDS, the relatively new treatment modalities that do not fit neatly with the Berlin definition, and the difficulty of making the diagnosis in resource-limited settings. We propose that attempts to revise the definition of ARDS should apply the framework originally developed by psychologists and social scientists and used by other medical disciplines to generate and assess definitions of clinical syndromes that do not have gold standards. This framework is structured around measures of reliability, feasibility, and validity. Future revisions of the definition of ARDS should contain the purpose, the methodology, and the framework for empirically testing any proposed definition. Attempts to revise critical illness syndromes\u2019 definitions usually hope to make them \u201cbetter\u201d; our recommendation is that future attempts use the same criteria used by other fields in defining what \u201cbetter\u201d means.<\/jats:p>","DOI":"10.1164\/rccm.202206-1048cp","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T16:09:35Z","timestamp":1663949375000},"page":"255-260","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":32,"title":["Rethinking Acute Respiratory Distress Syndrome after COVID-19: If a \u201cBetter\u201d Definition Is the Answer, What Is the Question?"],"prefix":"10.1093","volume":"207","author":[{"given":"V. Marco","family":"Ranieri","sequence":"first","affiliation":[{"name":"Alma Mater Studiorum \u2013 Universit\u00e0 di Bologna, Dipartimento di Scienze Mediche e Chirurgiche, IRCCS Policlinico di Sant\u2019Orsola, Anesthesia and Intensive Care Medicine, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Rubenfeld","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur S.","family":"Slutsky","sequence":"additional","affiliation":[{"name":"Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada; and"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, 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