Ryerson used the interstitial lung disease (ILD) type and GAP (gender, age, physiology) score to evaluate patients with interstitial lung disease. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of British Columbia, University of California San Francisco and Stanford University.
Patient selection: interstitial lung disease
Outcome: mortality
Parameters:
(1) type of interstitial lung disease (ILD)
(2) gender (G)
(3) age in years (A)
(4) FVC as percent of predicted (P)
(5) DLCO as percent of predicted (P)
Parameter
Finding
Points
type of ILD
idiopathic pulmonary fibrosis (IPF)
0
unclassifiable
0
connective tissue disease associated (CTD-ILD)
-2
idiopathic nonspecific interstitial pneumonia
-2
chronic hypersensitivity pneumonia (HP)
-2
gender
female
0
male
1
age
<= 60 years
0
61 to 65 years
1
> 65 years
2
FVC
> 75% of predicted
0
50 to 75% of predicted
1
< 50% of predicted
2
DLCO
> 55% of predicted
0
36 to 55% of predicted
1
<= 35% of predicted
2
not performed
3
total score =
= MAX(0,SUM(points for all 5 parameters))
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the worse the survival.
Score
1 Year Mortality
3 Year Mortality
0 or 1
3.1%
10.2%
2 or 3
8.8%
26.9%
4 or 5
18.2%
49.2%
6 to 8
33.5%
74.8%
Performance:
• The area under the ROC curve was 0.75.
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