Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: international consensus recommendations

Stefano Aliberti, Pieter C. Goeminne, Anne E. O'Donnell, Timothy R. Aksamit, Hamdan Al-Jahdali, Alan F. Barker, Francesco Blasi, Wim G. Boersma, Megan L. Crichton, Anthony De Soyza, Katerina E. Dimakou, Stuart J. Elborn, Charles Feldman, Harm Tiddens, Charles S. Haworth, Adam T. Hill, Michael R. Loebinger, Miguel Angel Martinez-Garcia, Jennifer J. Meerburg, Rosario MenendezLucy C. Morgan, Marlene S. Murris, Eva Polverino, Felix C. Ringshausen, Michal Shteinberg, Nicola Sverzellati, Gregory Tino, Antoni Torres, Thomas Vandendriessche, Montserrat Vendrell, Tobias Welte, Robert Wilson, Conroy A. Wong, James D. Chalmers

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

Bronchiectasis refers to both a clinical disease and a radiological appearance that has multiple causes and can be associated with a range of conditions. Disease heterogeneity and the absence of standardised definitions have hampered clinical trials of treatments for bronchiectasis and are important challenges in clinical practice. In view of the need for new therapies for non-cystic fibrosis bronchiectasis to reduce the disease burden, we established an international taskforce of experts to develop recommendations and definitions for clinically significant bronchiectasis in adults to facilitate the standardisation of terminology for clinical trials. Systematic reviews were used to inform discussions, and Delphi processes were used to achieve expert consensus. We prioritised criteria for the radiological diagnosis of bronchiectasis and suggest recommendations on the use and central reading of chest CT scans to confirm the presence of bronchiectasis for clinical trials. Furthermore, we developed a set of consensus statements concerning the definitions of clinical bronchiectasis and its specific signs and symptoms, as well as definitions for chronic bacterial infection and sustained culture conversion. The diagnosis of clinically significant bronchiectasis requires both clinical and radiological criteria, and these expert recommendations and proposals should help to optimise patient recruitment into clinical trials and allow reliable comparisons of treatment effects among different interventions for bronchiectasis. Our consensus proposals should also provide a framework for future research to further refine definitions and establish definitive guidance on the diagnosis of bronchiectasis.

Original languageEnglish (US)
Pages (from-to)298-306
Number of pages9
JournalThe Lancet Respiratory Medicine
Volume10
Issue number3
DOIs
StatePublished - Mar 2022

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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