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 Oct 01 TA - ERJ Open Research PG - 00399-2021 VI - 7 IP - 4 4099 - http://openres.ersjournals.com/content/7/4/00399-2021.short 4100 - http://openres.ersjournals.com/content/7/4/00399-2021.full SO - erjor2021 Oct 01; 7 AB - 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.A group of experts from EMBARC has generated a consensus definition of COPD and bronchiectasis association based on the coexistence of radiological findings, bronchial obstruction, compatible symptoms and exposure to smoke or toxic agents (ROSE criteria) https://bit.ly/3g3cdld