Defining and subphenotyping ARDS: insights from an international Delphi expert panel
21
Issued Date
2025-01-01
Resource Type
ISSN
22132600
eISSN
22132619
Scopus ID
2-s2.0-105004078324
Journal Title
The Lancet Respiratory Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
The Lancet Respiratory Medicine (2025)
Suggested Citation
Nasa P., Bos L.D., Estenssoro E., van Haren F.M.P., Neto A.S., Rocco P.R.M., Slutsky A.S., Schultz M.J. Defining and subphenotyping ARDS: insights from an international Delphi expert panel. The Lancet Respiratory Medicine (2025). doi:10.1016/S2213-2600(25)00115-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/109949
Title
Defining and subphenotyping ARDS: insights from an international Delphi expert panel
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Ministerio de Salud de la provincia de Buenos Aires
Li Ka Shing Knowledge Institute
NMC Specialty Hospital
Facultad de Ciencias Medicas, Universidad Nacional de La Plata
University of Toronto Faculty of Medicine
New Cross Hospital
Monash University
Hospital Israelita Albert Einstein
Medizinische Universität Wien
The Australian National University
Nuffield Department of Medicine
Hospital San Martin
Austin Hospital
Amsterdam UMC - University of Amsterdam
St George Hospital
Universidade Federal do Rio de Janeiro
Ministerio de Salud de la provincia de Buenos Aires
Li Ka Shing Knowledge Institute
NMC Specialty Hospital
Facultad de Ciencias Medicas, Universidad Nacional de La Plata
University of Toronto Faculty of Medicine
New Cross Hospital
Monash University
Hospital Israelita Albert Einstein
Medizinische Universität Wien
The Australian National University
Nuffield Department of Medicine
Hospital San Martin
Austin Hospital
Amsterdam UMC - University of Amsterdam
St George Hospital
Universidade Federal do Rio de Janeiro
Corresponding Author(s)
Other Contributor(s)
Abstract
Although the definition of acute respiratory distress syndrome (ARDS) has undergone numerous revisions aimed at enhancing its diagnostic accuracy and clinical practicality, the usefulness and precision of these definitions remain matters of ongoing discussion. In this Position Paper, we report on a Delphi study to reach a consensus on the conceptual model of ARDS, specifically identifying its defining components within clinical, research, and educational contexts as well as exploring the potential role of subphenotyping. We did a four-round Delphi study, involving experts in ARDS research and management from a diverse range of geoeconomic regions and professional backgrounds. Consensus was achieved for the conceptual model of ARDS; key components to be included for an ARDS definition in the context of research, education, and patient management; and the need for further research in subphenotyping ARDS. Additionally, we highlight knowledge gaps and research priorities that could guide future investigations in this area. Our study builds on previous non-Delphi-based consensus processes (eg, the new global definition of ARDS and recent society-based guidelines) by using a rigorous Delphi method that ensured panellist anonymity and used clear quantitative criteria to mitigate potential peer pressure and group conformity. The findings underscore the need to refine the ARDS definition to better account for the heterogeneity of clinical presentations and underlying pathophysiology, and to improve diagnostic precision, including the use of subphenotyping where appropriate.