{"doi":"10.1001/jama.2020.20089","title":"Addition of Inadvertently Omitted Financial Disclosures","abstract":"In Reply Variation in human airway tree structure can take many forms.As Dr Uzoigwe points out, our research team has, to date, investigated variations in airway branch patterns and airway tree caliber and their associations with COPD. 1,2We note that these associations are complex and agree that unraveling the causal relationship between airway tree structure and COPD requires further investigation.However, we disagree that airway branch patterns and dysanapsis are one and the same phenomenon.The association between dysanapsis and incident COPD remains large and statistically significant when additionally adjusted for the airway branch patterns previously linked to COPD 2 (eg, the adjusted rate ratio for incident COPD comparing the smallest with largest airway to lung ratio in the Multi-Ethnic Study of Atherosclerosis [MESA] Lung Study is 7.81 [95% CI, 3.68-16.57;P < .001]).As Uzoigwe points out, presence of an accessory central airway has been associated with COPD.Yet this common branch variant was not associated with differences in lung volume, 2 central airway tree caliber, 2 or dysanapsis (eg, the mean difference in airway to lung ratio compared with standard anatomy in the MESA Lung Study was 0.000 [95% CI -0.0003 to 0.0004; P = .93]).These observations support the hypothesis that variation in airway branch patterns and dysanapsis may be independent risk factors for COPD.Dysanapsis was also associated with incident COPD among those who have never smoked. 1 We therefore do not think that the association between dysanapsis and COPD is due to altered deposition of tobacco smoke and other particulates, although association modifications related to environmental exposures merit further investigation.","journal":"JAMA","year":2020,"id":133875,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9505,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[],"reference_count":4,"raw_metadata":null,"created_at":"2026-07-18T23:16:20.998822Z","pmid":"33079135","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}