Development of the Hypersensitivity pneumonitis South Asian Questionnaire for Exposure (HP-SAQE)

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Introduction: Environmental antigens trigger hypersensitivity pneumonitis (HP); effective management requires recognizing these exposures. An unmet need exists for a validated and quantitative tool tailored to each region to accurately assess the type and extent of exposure. This study aimed to develop an environmental questionnaire to identify exposures causing HP in South Asia. Methods: A systematic literature search was conducted on PUBMED and EMBASE (January 1990–May 2024) using the terms "hypersensitivity pneumonitis OR extrinsic allergic alveolitis". Identified exposures were evaluated through a two-round Delphi process involving 39 experts from India, Pakistan, Sri Lanka, and Nepal. Results: The search yielded 6,347 results, reduced to 5,170 after removing duplicates and applying inclusion criteria (Figure). A modified Delphi method was used, round 1 included Likert-scale and open-ended questions, followed by refined questions in Round 2. The final questionnaire included a qualitative section (17 questions) and a quantitative section (4 questions scoring exposure severity) on which consensus was obtained (>70% agreement). It was pilot-tested on 30 HP patients, improving clarity and understandability. Conclusion: A comprehensive questionnaire with qualitative and quantitative parameters was developed through systematic review and Delphi consensus, refined through pilot testing for improved usability. erj;66/suppl_69/PA3004/F1 F1 F1

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