Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/20495
Title
Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease
Author(s)
Smid, Dionne E | Franssen, Frits M. E | Gonik, Maria | Miravitlles, Marc | Casanova, Ciro | García-Cosío, Borja Autor/a del sistema sanitario público de las Islas Baleares Orcid | de Lucas, Pilar | Marin, Jose M | Martinez, Cristina | Mir, IsabelAutor/a del sistema sanitario público de las Islas Baleares | Soriano, Joan B.Autor/a del sistema sanitario público de las Islas Baleares | De Torres Tajes, Juan Pablo | Agusti, Alvar | Atalay, Nart B | Billington, Julia | Boutou, Afroditi K | Brighenti-Zogg, Stefanie | Chaplin, Emma | Coster, Samantha | Dodd, James W | Durr, Selina | Fernandez-Villar, Alberto | Groenen, Miriam T. J | Guimaraes, Miguel | Hejduk, Karel | Higgins, Victoria | Hopkinson, Nicholas S | Horita, Nobuyuki | Houben-Wilke, Sarah | Janssen, Daisy J. A | Jehn, Melissa | Joerres, Rudolf | Karch, Annika | Kelly, Julia L | Kim, Yu-Il | Kimura, Hiroshi | Koblizek, Vladimir | Kocks, Janwillem H | Kon, Samantha S. C | Kwon, Namhee | Ladeira, Ines | Lee, Sang-Do | Leuppi, Joerg D | Locantore, Nicholas | Lopez-Campos, Jose L | Man, William D-C | Maricic, Lana | Mendoza, Laura | Miedinger, David | Mihaltan, Florin | Minami, Seigo | van der Molen, Thys | Murrells, Trevor J | Nakken, Nienke | Nishijima, Yu | Norman, Ian J | Novotna, Barbora | O'Donnell, Denis E | Ogata, Yoshitaka | Pereira, Eanes D | Piercy, James | Price, David | Pothirat, Chaicharn | Raghavan, Natya | Ringbaek, Thomas | Sajkov, Dimitar | Sigari, Naseh | Singh, Sally | Small, Mark | da Silva, Guilherme F | Tanner, Rebecca J | Tsiligianni, Ioanna G | Tulek, Baykal | Tzanakis, Nikolaos | Vanfleteren, Lowie E. G. W | Watz, Henrik | Webb, Katherine A | Wouters, Emiel F. M | Xie, Guogang G | Yoshikawa, Masanori | Spruit, Martijn A
Date issued
2017-12-01
Citation
Smid Dionne E., Franssen Frits M. E., Gonik Maria, Miravitlles Marc, Casanova Ciro, Cosio Borja G, et al. Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease. J Am Med Dir Assoc. 2017 Dec 01;18(12):1097.e11-1097.e24.
Language
Inglés
Document type
research article
Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initiative for chronic Obstructive Lung Disease (GOLD) symptom measures, with an modified Medical Research Council dyspnea grade of 2 or higher as point of reference. Methods: After a computerized search, data from 41 cohorts and whose authors agreed to provide data were pooled. COPD studies were eligible for analyses if they included, at least age, sex, post-bronchodilator spirometry, modified Medical Research Council, and COPD Assessment Test (CAT) total scores. Main outcomes: Receiver operating characteristic curves and the Youden index were used to determine the best calibration threshold for CAT, COPD Clinical Questionnaire, and St. Georges Respiratory Questionnaire total scores. Following, GOLD A/B/C/D frequencies were calculated based on current cut-points and the newly derived cut-points. Findings: A total of 18,577 patients with COPD [72.0% male; mean age: 66.3 years (standard deviation 9.6)] were analyzed. Most patients had a moderate or severe degree of airflow limitation (GOLD spirometric grade 1, 10.9%; grade 2, 46.6%; grade 3, 32.4%; and grade 4, 10.3%). The best calibration threshold for CAT total score was 18 points, for COPD Clinical Questionnaire total score 1.9 points, and for St. Georges Respiratory Questionnaire total score 46.0 points. Conclusions: The application of these new cut-points would reclassify about one-third of the patients with COPD and, thus, would impact on individual disease management. Further validation in prospective studies of these new values are needed.
Subject
MESH
Disease Progression | Aged | Age Factors | Risk Assessment | Pulmonary Disease, Chronic Obstructive | Symptom Assessment | Humans | Middle Aged | Global Health | Male | Severity of Illness Index | Sex Factors | Female | Evidence-Based Medicine | Practice Guidelines as Topic | Sickness Impact Profile
DECS
Guías de Práctica Clínica como Asunto | Perfil de Impacto de Enfermedad | Medicina Basada en la Evidencia | Salud Global | Femenino | Evaluación de Síntomas | Masculino | Factores Sexuales | Enfermedad Pulmonar Obstructiva Crónica | Humanos | Persona de Mediana Edad | Factores de Edad | Anciano | Medición de Riesgo | Índice de Severidad de la Enfermedad | Progresión de la Enfermedad
Online version
DOI
Collections
- Investigación > IIS > IdisBa - Instituto de Investigación Sanitaria Illes Balears (Baleares)
- Investigación > IIS > IIS Aragón - Instituto de Investigación Sanitaria Aragón (Aragón)
- Investigación > IIS > IBIS - Instituto de Biomedicina de Sevilla (Andalucía)
- Investigación > IIS > IIS-PRINCESA - Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (Madrid)
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