Kojima, Kazuaki
Ogata, Hiroaki
Tsubouchi, Kazuya
Takano, Tomotsugu
Ichiki, Katsuyuki
Torii, Ryo
Takata, Shohei
Nakagaki, Noriaki
Yoshida, Makoto
Kitasato, Yasuhiko
Tobino, Kazunori
Harada, Eiji
Wataya, Hiroshi
Ishii, Hiroshi
Ogawa, Tomohiro
Kawasaki, Masayuki
Fujita, Masaki
Yatera, Kazuhiro
Zaizen, Yoshiaki
Nakanishi, Yoichi
Okamoto, Isamu
Funding for this research was provided by:
the Clinical Research Promotion Foundation 2024 of Japan
the Broad-Area, Network-Based Project to Drive Clinical Research at Kyushu University Hospital
the Diffuse Lung Diseases Research Group from the Ministry of Health, Labor and Welfare of Japan
the Ministry of Education, Culture, Sports, Science and Technology of Japan
Article History
Received: 28 January 2026
Accepted: 25 September 2026
First Online: 29 September 2026
Declarations
Competing interests: The authors declare no competing interests.
Ethics approval and consent to participate: This prospective, multicenter, observational study was approved by the Institutional Review Board of Kyushu University (approval numbers: #25–135 [August 23, 2013] and #555-00 [August 27, 2013]), as well as by the Institutional Review Boards of all participating hospitals, including: Kirigaoka Tsuda Hospital (#5); NHO Fukuokahigashi Medical Center (#25-2-4); Fukuoka University Chikushi Hospital (#R13-030); Japan Community Health Care Organization Kurume General Hospital (#133); Kurume University School of Medicine (#168); University of Occupational and Environmental Health, Japan (#H25-108); NHO Omuta National Hospital (#25 − 20); Fukuoka University School of Medicine (#13-11-06); NHO Fukuoka National Hospital (#25 − 21); Hamanomachi Hospital (#2013-26); Japan Community Health Care Organization Kyushu Hospital (#276); Steel Memorial Yawata Hospital (#13–54); St. Mary Hospital (#13-1019); Aso Iizuka Hospital (#25–189); Fukuoka Sanno Hospital (#FS-81); Kyushu Central Hospital (#62); NHO Kokura Medical Center (#141); Kyushu Rosai Hospital (#15-7-1); and Japanese Red Cross Fukuoka Hospital (#250). In addition, the following three institutions—Japan Community Health Care Organization Fukuoka Yutaka Central Hospital, Nishifukuoka Hospital, and Saiseikai Iizuka Kaho Hospital—were reviewed and approved by the Central Institutional Review Board of the Clinical Trial Network Fukuoka (approval number: #13-E14). For institutions where approval numbers are not officially assigned according to their regulations, a copy of the original approval document was submitted to the journal. The institutions listed above are representative participating centers and are not intended to be exhaustive. All the ethics committees involved in this study are based in Japan. Written informed consent was obtained from all patients. All study procedures were performed in accordance with the ethical standards of the Declaration of Helsinki.