TY - JOUR T1 - Development and validation of an interstitial lung disease exposure questionnaire for Sub-Saharan Africa JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00205-2022 SP - 00205-2022 AU - Peter Jackson AU - Roma Padalkar AU - Winceslaus Katagira AU - Kevin Mortimer AU - Natalie A. Rykiel AU - Nicole M. Robertson AU - Suzanne L. Pollard AU - Patricia Alupo AU - William Checkley AU - Bruce Kirenga AU - Trishul Siddharthan Y1 - 2022/01/01 UR - http://openres.ersjournals.com/content/early/2022/06/09/23120541.00205-2022.abstract N2 - Background ATS/ERS guidelines recommend context-specific exposure assessments to diagnose interstitial lung disease (ILD). In sub-Saharan Africa (sSA) ILD diagnoses are rare, and locally validated ILD exposure questionnaires are not used.Methods A physician-administered ILD exposure questionnaire was developed using a 4-step mixed-methods modified Delphi approach. First, ILD questionnaires from high-income countries and pneumotox.com data were reviewed, compiled, and face-validated. Second, a local pilot-group of ILD experts ranked item relevance utilizing a Likert scale and suggested additions. Third, questionnaire format and pilot rankings were addressed in focus group discussion which was analyzed using grounded theory. Finally, following focus group discussion modifications, the resulting items (with 3 duplicate item groups for evaluation of internal consistency) were ranked for importance by members of the pan-African Thoracic Society (PATS).Results Face-validation resulted in 82 items in four categories: illicit drugs/tobacco, environmental exposures, occupations, and medications. Pilot-group (n=10) ranking revealed 27 outliers and 30 novel suggestions. Focus group discussion (n=12) resulted in 10 item deletions, 14 additions and 22 re-wordings; themes included desire for extensive questionnaires and stigma sensitivity. Final validation involved 58 PATS members (average age 46 (sd 10.6), 76% male, from 17 countries) ranking 84 items derived from previous steps and 3 duplicate question groups. The questionnaire was internally consistent (Chronbach-alpha >0.80) and ultimately included 73 items.Conclusion This mixed-methods study included experts from 17 countries in sSA and successfully developed a 73 item ILD exposure questionnaire for sSA. African pulmonary experts valued region-specific additions and ranked several items from existing ILD questionnaires as un-important.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: Peter Jackson has nothing to disclose.Conflict of interest: Roma Padalkar has nothing to disclose.Conflict of interest: Winceslaus Katagira has nothing to disclose.Conflict of interest: Kevin Mortimer has nothing to disclose.Conflict of interest: Natalie A. Rykiel has nothing to disclose.Conflict of interest: Nicole M. Robertson has nothing to disclose.Conflict of interest: Suzanne L. Pollard has nothing to disclose.Conflict of interest: Patricia Alupo has nothing to disclose.Conflict of interest: William Checkley has nothing to disclose.Conflict of interest: Bruce Kirenga has nothing to disclose.Conflict of interest: Trishul Siddharthan has nothing to disclose. ER -