ROSE: radiology, obstruction, symptoms and exposure - a Delphi consensus definition of the association of COPD and bronchiectasis by the EMBARC Airways Working Group

Introduction The coexistence of COPD and bronchiectasis seems to be common and associated with a worse prognosis than for either disease individually. However, no definition of this association exists to guide researchers and clinicians. Methods We conducted a Delphi survey involving expert pulmonologists and radiologists from Europe, Turkey and Israel in order to define the COPD- [bronchiectasis] BE association. A panel of 16 experts from EMBARC selected 35 statements for the survey after reviewing scientific literature. Invited participants, selected on the basis of expertise, geographical and sex distribution, were asked to express agreement on the statements. Consensus was defined as a score of >= 6 points (scale 0 to 9) in >= 70% of answers across two scoring rounds. Results 102 (72.3%) out of 141 invited experts participated in the first round. Their response rate in the second round was 81%. The final consensus definition of COPD-BE association was: The coexistence of (1) specific radiological findings (abnormal bronchial dilatation, airways visible within 1 cm of pleura and/or lack of tapering sign in >= 1 pulmonary segment and in >1 lobe) with (2) an obstructive pattern on spirometry ([forced expiratory volume in 1 s] FEV1/[forced vital capacity] FVC <0.7), (3) at least two characteristic symptoms (cough, expectoration, dyspnoea, fatigue, frequent infections) and (4) current or past exposure to smoke (>= 10 pack-years) or other toxic agents (biomass, etc.). These criteria form the acronym ROSE (Radiology, Obstruction, Symptoms, Exposure). Conclusions The Delphi process formulated a European consensus definition of COPD-BE association. We hope this definition will have broad applicability across clinical practice and research in the future.

Automated summary

The study developed a European consensus definition of the coexistence of COPD and bronchiectasis through a Delphi survey, aiming for broad applicability in clinical practice and research in the future.