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Original Research: Diffuse Lung Disease |

Validation of the GAP Score in Korean Patients With Idiopathic Pulmonary FibrosisGAP Score in Idiopathic Pulmonary Fibrosis

Eun Sun Kim, MD; Sun Mi Choi, MD; Jinwoo Lee, MD; Young Sik Park, MD; Chang-Hoon Lee, MD; Jae-Joon Yim, MD; Chul-Gyu Yoo, MD; Young Whan Kim, MD; Sung Koo Han, MD; Sang-Min Lee, MD
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

CORRESPONDENCE TO: Sang-Min Lee, MD, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, 101, Daehang-no, Jongno-gu, Seoul 110-744, Korea; e-mail: sangmin2@snu.ac.kr


FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(2):430-437. doi:10.1378/chest.14-0453
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BACKGROUND:  No study has determined whether the risk of mortality predicted by the GAP (gender, age, and physiologic variables) model matches the observed mortality from idiopathic pulmonary fibrosis (IPF) in non-Western populations. We evaluated the clinical course of IPF and validated the GAP model in Korean patients with IPF.

METHODS:  We included 268 patients who received a diagnosis of IPF at Seoul National University Hospital between 2005 and 2009. For each patient, demographics and clinical data, such as lung physiologic parameters at IPF diagnosis, were evaluated. We validated the GAP model using discrimination and calibration to predict the risk of death in Korean patients with IPF.

RESULTS:  The study population comprised 181 men and 87 women (mean age, 65.9 years). The mean baseline % predicted FVC was 77, and % predicted diffusing capacity of lung for carbon monoxide was 65.9. A total of 157 deaths (58.6%) occurred during follow-up, and the median time to death was 4.64 years. The observed cumulative mortality at 1, 2, and 3 years was 10.4%, 20.9%, and 31.0%, respectively. The GAP model produced estimates of 1-year mortality risk consistent with the observed data (C statistic: GAP calculator, 0.74; GAP index and staging system, 0.72; P < .29). However, calibration of the GAP model at 3 years was not satisfactory.

CONCLUSIONS:  The GAP model showed similar discrimination power compared with the original cohort but did not predict the 3-year risk of death accurately. Further multinational validation studies are needed.

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