Reply to Dournes and Benlala: hierarchical computed tomography scoring systems cannot discriminate between reversible bronchiectasis and mucus plugs

In the letter to the Journal by Dournes and Benlala referring to our recent paper, the authors state that hierarchical computed tomography scoring systems cannot discriminate between reversible bronchiectasis and mucus plugs. This is not correct. Existing scoring systems cannot determine whether structural abnormalities in specific airways switch from one hierarchical tag to another between scans; however, scoring systems assess changes for the whole lung or at a lobar level, as opposed to a selected bronchus artery pair. Perth Rotterdam Annotated Grid Morphometric Analysis - Cystic Fibrosis (PRAGMA-CF) has been well validated and proven to be more sensitive to detect and track airway disease in many longitudinal cohort studies than the older, less-developed scoring systems referred to by the authors. The Real World Clinical Outcomes with Novel Modulator Therapy Combinations in People with Cystic Fibrosis (RECOVER) study involved prestudy standardization of scanner imaging outputs from all sites and spirometry control during scanning to standardize lung volumes. Intraclass correlation coefficients in our study for measurements of %Bronchiectasis, %wall thickening, and %Mucus plugging were excellent (>0.8).</p

Demographics characteristics and HBsAg, anti-HBc and anti-HBs positive results, NT residents tested for HBV in 2007–2011, by Indigenous status and sex.

<p>Demographics characteristics and HBsAg, anti-HBc and anti-HBs positive results, NT residents tested for HBV in 2007–2011, by Indigenous status and sex.</p

Interrupted time series analysis looking at HBsAg prevalence trends for (A) Indigenous, (B) non-Indigenous and (C) total population pre and post 1990 by birth cohort.

<p>Interrupted time series analysis looking at HBsAg prevalence trends for (A) Indigenous, (B) non-Indigenous and (C) total population pre and post 1990 by birth cohort.</p

Numbers of people who had one or more hepatitis B serology markers tested between 2007 and 2011 inclusive and the proportion of the NT population they represent detailed by Indigenous status and age group at the time of testing.

<p>Numbers of people who had one or more hepatitis B serology markers tested between 2007 and 2011 inclusive and the proportion of the NT population they represent detailed by Indigenous status and age group at the time of testing.</p

Cladistic association analysis: <i>P</i>-values for differences in phyla and genera between airway levels in adult subjects.

<p>The numbers of sequences are shown for each split level.</p>*<p>Only significant P values are shown. The significance levels have been Bonferroni corrected for multiple comparisons.</p

Cladistic association analysis: <i>P</i>-values for differences in phyla and genera between broncho-alveolar lavage in difficult childhood asthmatics and control subjects.

<p>The numbers of sequences are shown for each split level.</p>*<p>Only significant P values are shown. The significance levels have been Bonferroni corrected for multiple comparisons.</p

Adult Patient Characteristics.

*<p>based on the GINA criteria (<a href="http://www.ginasthma.com/" target="_blank">http://www.ginasthma.com/</a>).</p

Percentage distribution of common phyla and genera at different airway levels (nose, OP and LUL), subdivided into the seven most frequent genera (<i>Croynebacterium</i>, <i>Prevotella</i>, <i>Staphylococcus</i>, <i>Streptococcus</i>, <i>Veilonella</i>, <i>Haemophilus and Neisseria</i>) found in the samples.

<p>Percentage distribution of common phyla and genera at different airway levels (nose, OP and LUL), subdivided into the seven most frequent genera (<i>Croynebacterium</i>, <i>Prevotella</i>, <i>Staphylococcus</i>, <i>Streptococcus</i>, <i>Veilonella</i>, <i>Haemophilus and Neisseria</i>) found in the samples.</p

Characteristics of childhood subjects.

<p>Characteristics of childhood subjects.</p

Phylogenetic analysis of bacterial <i>16S rRNA</i> DNA from the nose, oropharynx (OP) and left upper lobe (LUL) in adult patients with COPD (C) or asthma (A) and healthy controls (N).

<p>The numbers of <i>16S rRNA</i> gene phylotypes (OTUs) were calculated at 97% sequence identity and single-sequence OTUs omitted. OTU designations are located at the termination of each branch and represent potential organism names. Abundance of OTUs in each subject is indicated by different coloured squares (Yellow = 1 single OTU, Orange = 3–10%, Red = 10–20% and Black≥20%).</p