Background Idiopathic pulmonary fibrosis (IPF) is characterized by progressive fibrosis and declining quality of life. Patient-reported outcomes (PROs) provide a more comprehensive understanding of a patient’s experience and health status than clinical measures (COs) alone, capturing how patients feel, function, and experience their health. However, the relationship between PROs and COs remains incompletely understood in this population.

Methods We performed a secondary analysis of data from the YES-IPF trial, examining 60 IPF patients who completed a 12-week modified yoga program or continued usual activities. Pearson correlations between 21 PROs and 6 COs (FVC: absolute and percent-predicted, DLCO: absolute and percent-predicted, 6-minute walk test, and GAP: Gender-Age-Physiology index) were assessed at baseline and week. p- values were adjusted using the Benjamini-Hochberg method across 21 PROs for each CO measured.

Findings Several significant correlations were observed between PROs and COs; key findings include total L-IPF correlating with absolute FVC having baseline r = -0.33 (p = 0.03) and 12-week r = 0.42 (p < 0.01), total L-IPF correlating with 6MWT having baseline r = -0.43 (p < 0.01) and 12-week r = -0.37 (p = 0.02), shortness of breath R-scale-PF correlating with absolute DLCO having baseline r = -0.35 (p = 0.04) and 12-week r = -0.49 (p < 0.01), total KBILD correlating with percent-predicted FVC having baseline r = 0.38 (p = 0.03) and 12-week r = 0.43 (p < 0.01), and K-BILD Breathlessness and Activities score correlating with GAP score having baseline r = -0.42 (p = 0.02) and 12-week r = -0.40 (p = 0.02).

Interpretation In IPF patients, breathlessness-specific PROs report correlation with COs of disease severity, while sleep-related and psychological domains demonstrate weaker or minimal correlations. This highlights that PROs and traditional COs measure related but distinct aspects of IPF, supporting their complementary use in clinical trials and patient care.

The authors have declared no competing interest.

NCT02848625

This study did not receive any funding.

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This study was a non-blinded, single center, randomized pilot trial conducted by the Center for Interstitial Lung Diseases at the University of Washington Medical Center. It was approved by the Institutional Review Board at the University of Washington and registered with ClinicalTrials.gov (NCT02848625).

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1. Soumik Purkayastha: Data analyses, interpretation of result, writing first draft, revised versions and collated inputs from all authors of the manuscript.

2. Suha Kadura: Data gathering, interpretation of result, writing first draft, revised versions and collated inputs from all authors of the manuscript.

3. Cathie Spino: Reviewed data analyses and interpretation, reviewed manuscript and provided input.

4. Ganesh Raghu: Designed the trial and study protocol, enrolled consenting participants in the study, interpretation of results, supervised the conduct of trial and execution of the trial; manuscript writing.

Funding No funding support was received for this study.

Trial Registration Registered with ClinicalTrials.gov (NCT0284862)

All data produced in the present study are available upon reasonable request to the authors.