BACKGROUND: Outcome surrogates are indicators that reflect, rather than directly measure, patient benefit. In order to provide useful results, however, outcome surrogates must be carefully chosen and must meet specific criteria. OBJECTIVE: To support development of high-resolution computed tomography (HRCT) as an outcome surrogate in cystic fibrosis (CF) by demonstrating the ability of HRCT to show short-term improvement in the appearance of the lungs in children with CF. MATERIALS AND METHODS: HRCT was performed at admission and after discharge on 8 children during 15 admissions for acute pulmonary exacerbation of CF. Three radiologists scored each study separately, then compared admission and discharge pairs. RESULTS: HRCT scores improved in 13/15 admissions. Mean score decreased from 25 to 22. The decrease was significant (P = 0.014). Comparison of admission and discharge scans showed improvement in peribronchial thickening (P = 0.007), mucous plugging (P = 0.002), and overall appearance (P = 0.025). CONCLUSION: HRCT has the potential to be a useful outcome surrogate in CF. A necessary attribute of an outcome surrogate is that it improves rapidly with effective therapy. Despite widespread belief among radiologists and pulmonologists that HRCT meets this criterion, no previous report has demonstrated this ability in children. These findings support further development of HRCT as an outcome surrogate in children with CF.
BACKGROUND: Outcome surrogates are indicators that reflect, rather than directly measure, patient benefit. In order to provide useful results, however, outcome surrogates must be carefully chosen and must meet specific criteria. OBJECTIVE: To support development of high-resolution computed tomography (HRCT) as an outcome surrogate in cystic fibrosis (CF) by demonstrating the ability of HRCT to show short-term improvement in the appearance of the lungs in children with CF. MATERIALS AND METHODS: HRCT was performed at admission and after discharge on 8 children during 15 admissions for acute pulmonary exacerbation of CF. Three radiologists scored each study separately, then compared admission and discharge pairs. RESULTS: HRCT scores improved in 13/15 admissions. Mean score decreased from 25 to 22. The decrease was significant (P = 0.014). Comparison of admission and discharge scans showed improvement in peribronchial thickening (P = 0.007), mucous plugging (P = 0.002), and overall appearance (P = 0.025). CONCLUSION: HRCT has the potential to be a useful outcome surrogate in CF. A necessary attribute of an outcome surrogate is that it improves rapidly with effective therapy. Despite widespread belief among radiologists and pulmonologists that HRCT meets this criterion, no previous report has demonstrated this ability in children. These findings support further development of HRCT as an outcome surrogate in children with CF.
Authors: Edwin J R van Beek; Catherine Hill; Neil Woodhouse; Stanislao Fichele; Sally Fleming; Bridget Howe; Sandra Bott; Jim M Wild; Christopher J Taylor Journal: Eur Radiol Date: 2006-08-29 Impact factor: 5.315
Authors: Emily M DeBoer; Waldemar Swiercz; Sonya L Heltshe; Margaret M Anthony; Paul Szefler; Rebecca Klein; John Strain; Alan S Brody; Scott D Sagel Journal: Chest Date: 2014-03-01 Impact factor: 9.410
Authors: Philip M Farrell; Jannette Collins; Lynn S Broderick; Michael J Rock; Zhanhai Li; Michael R Kosorok; Anita Laxova; William M Gershan; Alan S Brody Journal: Radiology Date: 2009-08 Impact factor: 11.105