PT - JOURNAL ARTICLE AU - Letizia Traversi AU - Marc Miravitlles AU - Miguel Angel Martinez-Garcia AU - Michal Shteinberg AU - Apostolos Bossios AU - Katerina Dimakou AU - Joseph Jacob AU - John R. Hurst AU - Pier Luigi Paggiaro AU - Sebastian Ferri AU - Georgios Hillas AU - Jens Vogel-Claussen AU - Sabine Dettmer AU - Stefano Aliberti AU - James D. Chalmers AU - Eva Polverino TI - ROSE: Radiology, Obstruction, Symptoms and Exposure, a Delphi consensus definition of the association of COPD and Bronchiectasis by the EMBARC Airways Working Group AID - 10.1183/23120541.00399-2021 DP - 2021 Jan 01 TA - ERJ Open Research PG - 00399-2021 4099 - http://openres.ersjournals.com/content/early/2021/08/12/23120541.00399-2021.short 4100 - http://openres.ersjournals.com/content/early/2021/08/12/23120541.00399-2021.full AB - Introduction The coexistence of chronic obstructive pulmonary disease (COPD) and bronchiectasis (BE) 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-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 gender 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 A-hundred-and-two (72.3%) out of 141 invited experts participated 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 (FEV1/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.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Traversi has nothing to disclose.Conflict of interest: Dr. Miravitlles reports personal fees from Astra Zeneca, personal fees from Boheringer Ingelheim, personal fees from Chiesi, personal fees from Cipla, personal fees from Menarini, personal fees from Rovi, personal fees from Bial, personal fees from Sandoz, personal fees from Zambon, personal fees from CLS Behring, grants and personal fees from Grifols, personal fees from Novartis, grants and personal fees from GlaxoSmithKline, from Gebro Pharma, from Kamada, from Laboratorios Esteve, from Ferrer, from Mereo Biopharma, from Verona Pharma, from TEVA, from Spin Therapeutics, from PH Pharma, from Sanofi, outside the submitted work; .Conflict of interest: Dr. Martinez-Garcia reports personal fees from Grifols, grants and personal fees from TEVA, personal fees from Novartis, personal fees from Zambon, grants and personal fees from Philips , grants and personal fees from Vitalair, personal fees from Chiesi, personal fees from AZ, personal fees from GSK, outside the submitted work; .Conflict of interest: Dr. Shteinberg reports grants and personal fees from GSK, grants and personal fees from Novartis, grants from Trudell Pharma, personal fees from Actelion, personal fees from Boehringer Ingelheim, personal fees from Rafa, personal fees from Astra Zeneca, personal fees from TEVA, personal fees from Kamada, from Horizon pharma, from Vertex pharmaceuticals, outside the submitted work; .Conflict of interest: Dr. Bossios reports personal fees from GlaxoSmithKline, personal fees from TEVA, personal fees from Novartis, personal fees from Sanofi, personal fees from AstraZeneca, outside the submitted work; .Conflict of interest: Dr. Dimakou reports personal fees from Chiesi, personal fees from AstraZeneca, personal fees from Pfizer, personal fees from Boehringer Ingelheim, personal fees from Novartis, personal fees from GlaxoSmithKline, personal fees from Menarini, outside the submitted work; .Conflict of interest: Dr. Jacob reports grants from Wellcome Trust Clinical Research Career Development , grants from Roche, grants from Boheringer Ingelheim, grants from Novartis, grants from GlaxoSmithKline, grants from NHSX, outside the submitted work; .Conflict of interest: Dr. Hurst reports personal fees from AstraZeneca, personal fees from Boheringer Ingelheim, personal fees from Chiesi, personal fees from Novartis, outside the submitted work; .Conflict of interest: Dr. Paggiaro reports personal fees from Alk-Abellò, personal fees from AstraZeneca, personal fees from Chiesi, personal fees from GSK, personal fees from Guidotti, personal fees from Menarini, personal fees from Mundipharma, personal fees from Novartis, personal fees from Sanofi, outside the submitted work; .Conflict of interest: Dr. Ferri has nothing to disclose.Conflict of interest: Dr. Hillas reports personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, personal fees from CLS Behring, personal fees from ELPEN, personal fees from Innovis, personal fees from GSK, personal fees from Menarini, personal fees from Novartis, personal fees from Pharmaten, personal fees from UCB, outside the submitted work.Conflict of interest: Dr. Vogel-Claussen reports grants and personal fees from Siemens Healthineers, grants and personal fees from AstraZeneca, grants and personal fees from GSK, grants and personal fees from Novartis, grants and personal fees from Boehringer Ingelheim, outside the submitted work.Conflict of interest: Dr. Dettmer has nothing to disclose.Conflict of interest: Dr. Aliberti reports personal fees from Bayer Helthcare, personal fees from Grifols, personal fees from AstraZeneca, personal fees from Zambon, grants and personal fees from Chiesi, grants and personal fees from INSMED, personal fees from GlaxoSmithKline, personal fees from Menarini, personal fees from ZetaCube Srl, grants from Fisher & Paykel, outside the submitted work.Conflict of interest: Dr. Chalmers reports grants and personal fees from Astrazeneca, grants and personal fees from Boehringer-ingelheim, personal fees from Chiesi, grants and personal fees from Glaxosmithkline, grants from Gilead sciences, grants and personal fees from Novartis , grants and personal fees from Insmed, personal fees from Janssen, personal fees from Zambon, grants and personal fees from Grifols, outside the submitted work.Conflict of interest: Dr. Polverino reports personal fees from Bayer, grants and personal fees from Grifols, personal fees from Insmed, personal fees from Chiesi, personal fees from Menarini, personal fees from Zembon, personal fees from Pfizer, outside the submitted work.