{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T22:25:18Z","timestamp":1757543118489,"version":"3.32.0"},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n<jats:title>Background &amp; objectives<\/jats:title>\n<jats:p>The co-presence of non-emphysematous airflow obstruction in interstitial Lung disease (ILD) is not elaborated. The present study aims the job with spirometry.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>ILD affected individuals with or without airflow obstruction (FEV1\/FVC&lt;0.7 or &gt;0.7) on spirometry were compared in terms of FEV1 and FEF<jats:sup>25-75<\/jats:sup> derived variables [FEF<jats:sup>25-75<\/jats:sup> (%-predicted), FEV1-FEF<jats:sup>25-75<\/jats:sup> distance, reversibility of FEV1 and FEF<jats:sup>25-75<\/jats:sup> to salbutamol and change in FEV1 and FEF<jats:sup>25-75<\/jats:sup> in %-predicted values]. Those showing significant difference (<jats:italic>P<\/jats:italic>=0.0001) suggesting obstruction were selected to draw respective receiver operating curve (ROC) curves to identify the best cut-off value for individual parameters. The efficacy of each surrogate was tested to identify airflow obstruction in both the initial \u2018overlap\u2019 as well as the \u2018unmixed\u2019 ILD affected individual for the presence of airflow obstruction.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>FEV1\/FVC identified 30 overlap from 235 ILDs. The FEF<jats:sup>25-75<\/jats:sup> (%-predicted), FEV1-FEF<jats:sup>25-75<\/jats:sup> distance, FEF<jats:sup>25-75<\/jats:sup> reversibility (in ml) and FEV1 (%-predicted) were significantly (<jats:italic>P<\/jats:italic>&lt;0.0001) different between the two groups. Of these, the FEF<jats:sup>25-75<\/jats:sup> (%-predicted) had high specificity and sensitivity (93.33 and 79.47%) to identify airflow limitation in the initial unmixed ILD-group. The surrogates with their cut off values identified 92 extra individuals making it 122\/235 (51.91%) of ILD having airflow obstruction. The \u2018unmixed\u2019 group showed higher frequency and degree of FEV1 reversibility.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Interpretation &amp; conclusions<\/jats:title>\n<jats:p>The findings of this study suggest that the airflow obstruction in ILD involves both the intrathoracic large and small airways. Although seemingly parallel, their relative status (qualitative and quantitative) needs research especially in light of the a etio pathology and the extent of involvement of ILD.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijmr_114_24","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T09:20:14Z","timestamp":1727774414000},"page":"70-77","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Covert airflow obstruction dominates the overt ones in interstitial lung disease: An appraisal"],"prefix":"10.25259","volume":"160","author":[{"given":"Parthasarathi","family":"Bhattacharyya","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayanti","family":"Karmakar","sequence":"additional","affiliation":[{"name":"Department of Pleuro-Parenchymal Diseases, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayoni","family":"Sengupta","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Circulation, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mintu","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avishek","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debkanya","family":"Dey","sequence":"additional","affiliation":[{"name":"Department of Airway Diseases, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuvam","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Airway Diseases, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srijita","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Airway Diseases, Institute of Pulmocare & Research (IPCR), Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"10.25259\/ijmr_114_24\/ref-1","doi-asserted-by":"crossref","first-page":"109073","DOI":"10.1016\/j.ejrad.2020.109073","article-title":"Traction bronchiectasis\/bronchiolectasis is associated with interstitial lung abnormality mortality","volume":"129","author":"Hida","year":"2020","journal-title":"Eur J Radiol"},{"key":"10.25259\/ijmr_114_24\/ref-2","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1148\/radiol.2462070712","article-title":"Fleischner society: Glossary of terms for thoracic imaging","volume":"246","author":"Hansell","year":"2008","journal-title":"Radiology"},{"key":"10.25259\/ijmr_114_24\/ref-3","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1136\/thorax.55.3.198","article-title":"Airflow obstruction in bronchiectasis: Correlation between computed tomography features and pulmonary function tests","volume":"55","author":"Roberts","year":"2000","journal-title":"Thorax"},{"key":"10.25259\/ijmr_114_24\/ref-4","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1016\/S2214-109X(22)00456-9","article-title":"Small airways obstruction and its risk factors in the burden of obstructive lung disease (BOLD) study: A multinational cross-sectional study","volume":"11","author":"Knox-Brown","year":"2023","journal-title":"Lancet Glob Health"},{"key":"10.25259\/ijmr_114_24\/ref-5","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1183\/09031936.05.00021005","article-title":"Combined pulmonary fibrosis and emphysema: A distinct underrecognized entity","volume":"26","author":"Cottin","year":"2005","journal-title":"Eur Respir J"},{"key":"10.25259\/ijmr_114_24\/ref-6","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4104\/pcrj.2010.00079","article-title":"Diagnostic assessment of patients with interstitial lung disease","volume":"20","author":"Gulati","year":"2011","journal-title":"Pri Care Resp J"},{"key":"10.25259\/ijmr_114_24\/ref-7","doi-asserted-by":"crossref","first-page":"167","DOI":"10.4104\/pcrj.2011.00103","article-title":"Accuracy of asthma and COPD diagnosis in Australian general practice: a mixed methods study","volume":"21","author":"Abramson","year":"2012","journal-title":"Pri Care Resp J"},{"key":"10.25259\/ijmr_114_24\/ref-9","first-page":"PA2926","article-title":"Overt and covert airflow limitations in DPLD: A spirometric appraisal","volume":"62","author":"Karmakar","year":"2023","journal-title":"Eur Respir J"},{"key":"10.25259\/ijmr_114_24\/ref-10","first-page":"350","article-title":"Small airways in children with allergic rhinoconjunctivitis: The potential role of a multicomponent nutraceutical","volume":"91","author":"Leonardi","year":"2020","journal-title":"Acta Biomed"},{"key":"10.25259\/ijmr_114_24\/ref-11","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1590\/S1806-37562016000000091","article-title":"Lung volumes and airway resistance in patients with a possible restrictive pattern on spirometry","volume":"42","author":"Schultz","year":"2016","journal-title":"J Bras Pneumol"},{"key":"10.25259\/ijmr_114_24\/ref-12","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1080\/17476348.2019.1674649","article-title":"The pragmatic role of FEF25-75 in asymptomatic subjects, allergic rhinitis, asthma, and in military setting","volume":"13","author":"Ciprandi","year":"2019","journal-title":"Expert Rev Respir Med"},{"key":"10.25259\/ijmr_114_24\/ref-13","doi-asserted-by":"crossref","first-page":"641","DOI":"10.2500\/ajr.2006.20.2914","article-title":"Role of FEF25\u201375 as an early marker of bronchial impairment in patients with seasonal allergic rhinitis","volume":"20","author":"Ciprandi","year":"2006","journal-title":"Am J Rhinol"},{"key":"10.25259\/ijmr_114_24\/ref-14","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1183\/09031936.05.00035205","article-title":"Interpretative strategies for lung function tests","volume":"26","author":"Pellegrino","year":"2005","journal-title":"Eur Respir J"},{"key":"10.25259\/ijmr_114_24\/ref-15","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.2147\/COPD.S261732","article-title":"FEF25-75% values in patients with normal lung function can predict the development of chronic obstructive pulmonary disease","volume":"15","author":"Kwon","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"10.25259\/ijmr_114_24\/ref-16","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s00408-010-9275-y","article-title":"Assessment of small-airways disease using alveolar nitric oxide and impulse oscillometry in asthma and COPD","volume":"189","author":"Williamson","year":"2011","journal-title":"Lung"},{"key":"10.25259\/ijmr_114_24\/ref-17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12931-019-1017-y","article-title":"The pathology of small airways disease in COPD: historical aspects and future directions","volume":"20","author":"Higham","year":"2019","journal-title":"Respir Res"},{"key":"10.25259\/ijmr_114_24\/ref-18","doi-asserted-by":"crossref","first-page":"3649","DOI":"10.1016\/j.jaip.2021.06.027","article-title":"FEF25-75% is a more sensitive measure reflecting airway dysfunction in patients with asthma: A comparison study using FEF25-75% and FEV1%","volume":"9","author":"Qin","year":"2021","journal-title":"J Allergy Clin Immunol Pract"},{"key":"10.25259\/ijmr_114_24\/ref-19","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.jaci.2006.05.010","article-title":"The lower airway pathology of rhinitis","volume":"118","author":"Ciprandi","year":"2006","journal-title":"J Allergy Clin Immunol"},{"key":"10.25259\/ijmr_114_24\/ref-20","first-page":"90","article-title":"Forced expiratory flow at 25\u201375% as a marker for airway hyper responsiveness in adult patients with asthma-like symptoms","volume":"17","author":"Raji","year":"2018","journal-title":"Tanaffos"},{"key":"10.25259\/ijmr_114_24\/ref-21","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jaci.2010.05.016","article-title":"FEF25-75 and FEV1\/FVC in relation to clinical and physiologic parameters in asthmatic children with normal FEV1 values","volume":"126","author":"Simon","year":"2010","journal-title":"J Allergy Clin Immunol"},{"key":"10.25259\/ijmr_114_24\/ref-22","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1378\/chest.14-1119","article-title":"Poor symptom control is associated with reduced CT scan segmental airway lumen area in smokers with asthma","volume":"147","author":"Thomson","year":"2015","journal-title":"Chest"},{"key":"10.25259\/ijmr_114_24\/ref-23","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/S1081-1206(10)61067-8","article-title":"Role of FEF25%\u201375% as a predictor of bronchial hyperreactivity in allergic patients","volume":"96","author":"Cirillo","year":"2006","journal-title":"Ann Allergy Asthma Immunol"},{"key":"10.25259\/ijmr_114_24\/ref-24","first-page":"S19","article-title":"Impaired FEF25-75 values may predict bronchial reversibility in allergic children with rhinitis or asthma","volume":"26","author":"Ciprandi","year":"2012","journal-title":"J Biol Regul Homeost Agents"},{"key":"10.25259\/ijmr_114_24\/ref-25","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jaci.2010.05.016","article-title":"FEF25-75 and FEV1\/FVC in relation to clinical and physiologic parameters in asthmatic children with normal FEV1 values","volume":"126","author":"Simon","year":"2010","journal-title":"J Allergy Clin Immunol"},{"key":"10.25259\/ijmr_114_24\/ref-26","first-page":"69","article-title":"Alternative functional criteria to assess airflow-limitation reversibility in asthma","volume":"21","author":"Tavares e Castro","year":"2015","journal-title":"Rev Port Pneumol"},{"key":"10.25259\/ijmr_114_24\/ref-27","first-page":"A002","article-title":"An efficient diagnosis of diffuse parenchymal lung disease from spirometry exploring the novel role of FEF25\u201375","volume":"43","author":"Dey","year":"2022","journal-title":"J Med Paediatr Oncol"},{"key":"10.25259\/ijmr_114_24\/ref-28","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4103\/lungindia.lungindia_263_19","article-title":"Hypersensitivity pneumonitis: Clinical manifestations\u2013Prospective data from the interstitial lung disease-India registry","volume":"36","author":"Singh","year":"2019","journal-title":"Lung India"},{"key":"10.25259\/ijmr_114_24\/ref-29","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1081\/COPD-200053377","article-title":"Minimal clinically important differences in COPD lung function","volume":"2","author":"Donohue","year":"2005","journal-title":"COPD"},{"key":"10.25259\/ijmr_114_24\/ref-30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12890-020-1147-5","article-title":"Health-related quality of life associates with change in FEV 1 in COPD: Results from the COSYCONET cohort","volume":"20","author":"Lutter","year":"2020","journal-title":"BMC Pulm Med"},{"key":"10.25259\/ijmr_114_24\/ref-31","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1136\/thoraxjnl-2012-202640","article-title":"Forced vital capacity as a primary end point in idiopathic pulmonary fibrosis treatment trials: Making a silk purse from a sow\u2019s ear","volume":"68","author":"Wells","year":"2013","journal-title":"Thorax"}],"container-title":["The Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ijmr.org.in\/covert-airflow-obstruction-dominates-the-overt-ones-in-interstitial-lung-disease-an-appraisal\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ijmr.org.in\/covert-airflow-obstruction-dominates-the-overt-ones-in-interstitial-lung-disease-an-appraisal\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T03:29:51Z","timestamp":1734665391000},"score":1,"resource":{"primary":{"URL":"http:\/\/ijmr.org.in\/covert-airflow-obstruction-dominates-the-overt-ones-in-interstitial-lung-disease-an-appraisal\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":30,"alternative-id":["10.25259\/ijmr_114_24"],"URL":"https:\/\/doi.org\/10.25259\/ijmr_114_24","relation":{},"ISSN":["0971-5916"],"issn-type":[{"type":"print","value":"0971-5916"}],"subject":[],"published":{"date-parts":[[2024,9,30]]},"article-number":"70"}}