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2. Additional file 1 of Comorbidities and mortality risk in adults younger than 50 years of age with chronic obstructive pulmonary disease

Author

Divo, Miguel J., Marin, José M., Casanova, Ciro, Cabrera Lopez, Carlos, Pinto-Plata, Victor M., Marin-Oto, Marta, Polverino, Francesca, de-Torres, Juan P., Billheimer, Dean, and Celli, Bartolome R.

Abstract

Additional file 1: Figure S1. Comorbidities prevalence bar graph comparing Young (≤ 50 years) and older (> 50 years) COPD patients. Figure S2. Kaplan–Meier survival curve comparing the three groups. In blue is the control group, red for “Young COPD” and green for the older COPD. Figure S3. Primary causes of death in the Young (< 50 years) and “Older” COPD patients (> 50 years). Table S1. Comorbidities prevalence comparison between Young COPD and controls. Table S2. Comorbidities prevalence comparing Young COPD and Old COPD.

Published
2022
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3. Sex differences between women and men with COPD: A new analysis of the 3CIA study

Author

Perez, Tamara Alonso, Castillo, Elena García, Ancochea, Julio, Pastor Sanz, María Teresa, Almagro, Pere, Martínez-Camblor, Pablo, Miravitlles, Marc, Rodríguez-Carballeira, Mónica, Navarro, Annie, Lamprecht, Bernd, Ramírez-García Luna, Ana S, Kaiser, Bernhard, Alfageme, Inmaculada, Casanova, Ciro, Esteban, Cristóbal, Soler-Cataluña, Juan J, De-Torres, Juan P, Celli, Bartolomé R, Marin, Jose M, Lopez-Campos, Jose L, Riet, Gerben Ter, Sobradillo, Patricia, Lange, Peter, Garcia-Aymerich, Judith, Anto, Josep M, Turner, Alice M, Han, MeiLan K, Langhammer, Arnulf, Sternberg, Alice, Leivseth, Linda, Puhan, Milo Alan, et al, and University of Zurich

Subjects
2740 Pulmonary and Respiratory Medicine, 610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Published
2020

4. Prognostic assessment in COPD without lung function: the B-AE-D indices

Author

Boeck, Lucas, Soriano, Joan B., Brusse-Keizer, Marjolein, Blasi, Francesco, Kostikas, Konstantinos, Boersma, Wim, Milenkovic, Branislava, Louis, Renaud, Lacoma, Alicia, Djamin, Remco, Aerts, Joachim, Torres, Antoni, Rohde, Gernot, Welte, Tobias, Martinez-Camblor, Pablo, Rakic, Janko, Scherr, Andreas, Koller, Michael, van der Palen, Job, Marin, Jose M., Alfageme, Inmaculada, Almagro, Pere, Casanova, Ciro, Esteban, Cristobal, Soler-Cataluña, Juan J., de-Torres, Juan P., Miravitlles, Marc, Celli, Bartolome R., Tamm, Michael, Stolz, Daiana, Universitat Autònoma de Barcelona, Pulmonologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, MUMC+: MA Med Staf Spec Longziekten (9), and Faculty of Behavioural, Management and Social Sciences

Subjects
Male, Exacerbation, Severity of Illness Index, Body Mass Index, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Forced Expiratory Volume, 030212 general & internal medicine, Longitudinal Studies, Lung, 2. Zero hunger, COPD, medicine.diagnostic_test, Glycopeptides, Middle Aged, Prognosis, 3. Good health, Respiratory Function Tests, Treatment Outcome, Cardiology, Female, METIS-318027, Risk assessment, Pulmonary and Respiratory Medicine, Spirometry, medicine.medical_specialty, Risk Assessment, External validity, 03 medical and health sciences, Copeptin, Internal medicine, Severity of illness, medicine, Humans, Mortality, Exercise, Aged, Inflammation, business.industry, Reproducibility of Results, medicine.disease, respiratory tract diseases, Oxygen, Dyspnea, 030228 respiratory system, Physical therapy, IR-101435, business, Body mass index
Abstract

Altres ajuts: A. Schötzau performed data management of PROMISE for which he received financial compensation.Thermo Scientific Biomarkers (Hennigsdorf, Germany) provided all the reagents for copeptin measurements. Several composite markers have been proposed for risk assessment in chronic obstructive pulmonary disease (COPD). However, choice of parameters and score complexity restrict clinical applicability. Our aim was to provide and validate a simplified COPD risk index independent of lung function. The PROMISE study (n=530) was used to develop a novel prognostic index. Index performance was assessed regarding 2-year COPD-related mortality and all-cause mortality. External validity was tested in stable and exacerbated COPD patients in the ProCOLD, COCOMICS and COMIC cohorts (total n=2988). Using a mixed clinical and statistical approach, body mass index (B), severe acute exacerbations of COPD frequency (AE), modified Medical Research Council dyspnoea severity (D) and copeptin (C) were identified as the most suitable simplified marker combination. 0, 1 or 2 points were assigned to each parameter and totalled to B-AE-D or B-AE-D-C. It was observed that B-AE-D and B-AE-D-C were at least as good as BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity), ADO (age, dyspnoea, airflow obstruction) and DOSE (dyspnoea, obstruction, smoking, exacerbation) indices for predicting 2-year all-cause mortality (c-statistic: 0.74, 0.77, 0.69, 0.72 and 0.63, respectively; Hosmer-Lemeshow test all p>0.05). Both indices were COPD specific (c-statistic for predicting COPD-related 2-year mortality: 0.87 and 0.89, respectively). External validation of B-AE-D was performed in COCOMICS and COMIC (c-statistic for 1-year all-cause mortality: 0.68 and 0.74; c-statistic for 2-year all-cause mortality: 0.65 and 0.67; Hosmer-Lemeshow test all p>0.05). The B-AE-D index, plus copeptin if available, allows a simple and accurate assessment of COPD-related risk. The B-AE-D indices allow a simple and accurate assessment of COPD-related risk in the absence of lung function

Published
2016

5. Screening of lung cancer with low radiation dose computed axial tomography

Author

Gonzalez, Jessica and de-Torres, Juan P.

Subjects
Cáncer de pulmón, Screening, TAC, Cribado, Lung cancer
Abstract

Resumen: El cáncer de pulmón (CP) es la causa de muerte por enfermedad maligna más frecuente. Al momento del diagnóstico, solo el 15% de los pacientes con cáncer de pulmón continúan con vida tras 5 añosporqueeste se realizahabitualmente en estadios avanzados. El cribado de CP con tomografía axial computarizada de baja dosis (TCBD)se ha propuesto como una estrategia para reducir la mortalidad mediante su detección precoz y tratamiento temprano. Es bien conocida la relación entre el tabaco y el CP, siendo el 90% de estos cánceres atribuidos ala exposición activa o pasiva al humo del cigarrillo. Entre los factores de riesgo (FR)más importantes pero infra reconocidos, estála enfermedad pulmonar obstructiva crónica (EPOC).Recientemente,el uso de la TCBDha permitido identificar a el enfisema pulmonarcomo otro importante FR. La asociación entre estas dos enfermedades (EPOC y enfisema) potencia el riesgo de desarrollar CP, lo que convierte a los fumadores con estas patologías en dianas ideales para los programas de cribado. Sin embargo, el equilibrio entre el beneficio y el daño ocasionado por el cribadoha generado un intenso debate, por lo que el desafío se sitúa en mejorar los criterios de inclusiónde los programas de cribado, minimizando el número de falsos positivos y el sobre diagnóstico. Esta revisión pretende destacarlos puntos más importantes sobre el cribado de cáncer de pulmón y realizar algunas recomendaciones para su puesta en marcha. Abstract: Lung cancer (PC) is the cause of death due to more frequent malignant disease. At the time of diagnosis, only 15% of patients with lung cancer remain alive after 5 years because this is usually done in advanced stages. CP Screening with Computed Low-dose Axial Tomography (BDT) has been proposed as a strategy to reduce mortality through early detection and early treatment. The relationship between smoking and CP is well known, with 90% of these cancers attributed to active or passive exposure to cigarette smoke. Chronic obstructive pulmonary disease (COPD) is the most important but underrecognized risk factor (RF). Recently, the use of BDT has allowed lung emphysema to be identified as another major FR. The association between these two diseases (COPD and emphysema) increases the risk of developing COP, which makes smokers with these pathologies an ideal target for screening programs. However, the balance between benefit and damage caused by screening has generated intense debate, so the challenge lies in improving the criteria for inclusion of screening programs, minimizing the number of false positives and over-diagnosis. This review aims to highlight the most important points about lung cancer screening and make some recommendations for its implementation.

Published
2017

6. COPD heterogeneity: Gender differences in the multidimensional BODE index

Author

de Torres, Juan P, Casanova, Ciro, de Garcini, Angela Montejo, Jaime, Armando Aguirre, and Celli, Bartolomé R

Subjects
Male, Age Factors, Gender, Walking, Middle Aged, Severity of Illness Index, humanities, Body Mass Index, Pulmonary Disease, Chronic Obstructive, Cross-Sectional Studies, Sex Factors, BODE index, Forced Expiratory Volume, COPD, Humans, Female, Original Research, Aged
Abstract

Background: The BODE index was recently validated as a multidimensional tool for the evaluation of patients with COPD. The influence of gender on the BODE index has not been studied. Hypothesis: The contribution of each component of the disease to the BODE index may differ according to gender. Methods: We evaluated age, forced expiratory volume in one second (FEV1), Modified Medical Research Council (MMRC) score, 6-min walk distance (6MWD), and body mass index (BMI) in 52 men and 52 women with COPD and the same BODE index. We compared the studied parameters between men and women and then performed a multiple regression analysis by gender. Results: We found statistically significant differences between men and women in all parameters: FEV1 % (55 ± 17 vs 63 ± 18, p < 0.001), MMRC [1 (0–2) vs 1 (1–2) p = 0.03], BMI [28 (26–30) vs 25 (22–30), p = 0.05], and 6MWD [546 (451–592) vs 462 (419–520), p = 0.001]. Multiple regression analysis revealed that each component of the BODE index had different weight (β standardized coefficient) in men and women respectively: FEV1% (0.74 vs 0.62), MMRC (0.31 vs 0.48), BMI (−0.09 vs −0.17), and 6MWD (0.13 vs 0.10). Conclusions: The contribution of each component to the BODE index differs by gender in subjects with similar BODE scores. Long term longitudinal studies will help determine the significance of our findings.

Published
2007

8. Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD

Author

Ramón Agüero, Eva Balcells, Pilar de Lucas-Ramos, Celia Lacarcel, Inmaculada Alfageme, Jose M. Marin, Carlos Javier Gutiérrez Cabrera, Victor Pinto-Plata, Miguel Divo, Juan P. de-Torres, Alfredo de Diego, Rafael Golpe, Myriam Calle-Rubio, Amalia Moreno, Ingrid Solanes, Juan B. Galdiz, José Luis López-Campos, Joan B. Soriano, Nuria Feu-Collado, Bartolome R. Celli, Juan José Soler-Cataluña, Antonia Fuster, Amparo Romero, Antonia Llunell, Borja G. Cosío, Cristina Martínez-González, Ciro Casanova, Margarita Marín, Germán Peces-Barba, [Casanova, Ciro] Hosp Univ Ntra Sra La Candelaria, Pulmonol Dept, Tenerife, Spain, [Celli, Bartolome R.] Brigham & Womens Hosp, Pulm & Crit Care Dept, 75 Francis St, Boston, MA 02115 USA, [Divo, Miguel] Brigham & Womens Hosp, Pulm & Crit Care Dept, 75 Francis St, Boston, MA 02115 USA, [de-Torres, Juan P.] Clin Univ Navarra, Pulm Dept, Pamplona, Spain, [Martinez-Gonzalez, Cristina] Hosp Cent Asturias, Pulm Dept, Oviedo, Spain, [Cosio, Borja G.] Hosp Son Espases IdISPa, Pulm Dept, Palma de Mallorca, Spain, [Cosio, Borja G.] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Peces-Barba, German] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Luis Lopez-Campos, Jose] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Pinto-Plata, Victor] Baystate Med Ctr, Springfield, MA USA, [de Lucas-Ramos, Pilar] Hosp Gregorio Maranon, Pulm Dept 1, Madrid, Spain, [Fuster, Antonia] Hosp Son Llatzer, Pulm Dept, Mallorca, Spain, [Peces-Barba, German] Fdn Jimenez Diaz, Pulm Dept, Madrid, Spain, [Calle-Rubio, Myriam] Univ Complutense Madrid, Fac Med, Med Dept, Hosp Clin San Carlos,Pulm Dept, Madrid, Spain, [Solanes, Ingrid] Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Pulm Dept, Barcelona, Spain, [Aguero, Ramon] Hosp Marques Valdecilla, Pulm Dept, Santander, Spain, [Feu-Collado, Nuria] Hosp Univ Reina Sofia, IMIBIC, UCO, Pulm Dept, Cordoba, Spain, [Alfageme, Inmaculada] Hosp Univ Valme, Pulm Dept, Seville, Spain, [De Diego, Alfredo] Hosp Univ La Fe, Pulm Dept, Valencia, Spain, [Romero, Amparo] Hosp Manacor, Pulm Dept, Mallorca, Spain, [Balcells, Eva] Hosp Mar, Pulm Dept, Barcelona, Spain, [Llunell, Antonia] Hosp Tarrasa, Pulm Dept, Tarrasa, Spain, [Galdiz, Juan B.] Hosp Cruces, Pulm Dept, Bilbao, Spain, [Marin, Margarita] Hosp Gen Castellon, Pulm Dept, Castellon de La Plana, Spain, [Moreno, Amalia] Hosp Parc Tauli, Pulm Dept, Barcelona, Spain, [Cabrera, Carlos] Hosp Dr Negrin, Pulm Dept, Las Palmas Gran Canaria, Spain, [Golpe, Rafael] Hosp Univ Lucus Augusti, Pulm Dept, Lugo, Spain, [Lacarcel, Celia] Hosp Ciudad Jaen, Pulm Dept, Jaen, Spain, [Soriano, Joan B.] Hosp Univ La Princesa IISP, Inst Invest, Madrid, Spain, [Luis Lopez-Campos, Jose] Hosp Univ Virgen Rocio, Inst Biomed Sevilla IBiS, Unidad Med Quirrurg Enfermedades Resp, Seville, Spain, [Soler-Cataluna, Juan J.] Hosp Arnau Vilanova, Pulm Dept, Valencia, Spain, [Marin, Jose M.] Hosp Univ Miguel Servet, IISAragon, CIBERES, Pulm Dept, Zaragoza, Spain, and AstraZeneca (Madrid, Spain)

Subjects
Male, Cohort Studies, Leukocyte Count, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Risk Factors, Forced Expiratory Volume, Prevalence, Medicine, Eosinophilia, 030212 general & internal medicine, Obstructive pulmonary-disease, COPD, Inhaled corticosteroids, respiratory system, Middle Aged, medicine.anatomical_structure, Cohort, Disease Progression, Female, medicine.symptom, Cohort study, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Efficacy, Guidelines, Exacerbations, 03 medical and health sciences, Internal medicine, Humans, In patient, Risk factor, Survival analysis, Aged, Clinical characteristics, business.industry, Biomarker, Eosinophil, medicine.disease, Survival Analysis, Asthma, respiratory tract diseases, Eosinophils, Dyspnea, 030228 respiratory system, Spain, Immunology, Fluticasone, business
Abstract

The impact of blood eosinophilia in chronic obstructive pulmonary disease (COPD) remains controversial.To evaluate the prevalence and stability of a high level of blood eosinophils (>= 300 cells.mu L-1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis.In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels = 300 cells.mu L-1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis.In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels = 300 cells.mu L-1 persisting over 2 years was not a risk factor for COPD exacerbations. High eosinophil count was associated with better survival.

Published
2017

9. 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

Masanori Yoshikawa, Daisy J.A. Janssen, Selina Dürr, Rudolf Joerres, Julia Billington, Nicholas Locantore, Florin Mihaltan, Sally Singh, Dimitar Sajkov, Thys van der Molen, Borja G. Cosío, Guilherme F. da Silva, Sarah Houben-Wilke, Ian Norman, Baykal Tulek, Jose M. Marin, David Miedinger, Samantha Coster, Janwillem W. H. Kocks, Sang Do Lee, Karel Hejduk, Juan P. de Torres, Maria Gonik, Mark Small, Samantha S.C. Kon, Nobuyuki Horita, Katherine A. Webb, Naseh Sigari, Ioanna Tsiligianni, Natya Raghavan, Yoshitaka Ogata, William D.-C. Man, Afroditi K. Boutou, Cristina Martínez, Marc Miravitlles, Lowie E.G.W. Vanfleteren, Miriam T.J. Groenen, Barbora Novotna, Isabel Mir, Miguel Guimaraes, Alvar Agusti, Nart Bedin Atalay, Dionne E. Smid, Trevor Murrells, Stefanie Brighenti-Zogg, Henrik Watz, Seigo Minami, José Luis López-Campos, Frits M.E. Franssen, Nicholas S Hopkinson, Pilar de Lucas-Ramos, Emiel F.M. Wouters, James Piercy, Melissa Jehn, Emma Chaplin, Vladimir Koblizek, Ciro Casanova, Nikolaos Tzanakis, Rebecca Tanner, Hiroshi Kimura, Lana Maricic, Nienke Nakken, David Price, Alberto Fernández-Villar, Denis E. O'Donnell, Annika Karch, Martijn A. Spruit, Yu-Il Kim, Joan B. Soriano, Ines Ladeira, Yu Nishijima, Namhee Kwon, Victoria Higgins, Laura Mendoza, Eanes Delgado Barros Pereira, Julia L. Kelly, Thomas Ringbaek, Guogang G. Xie, Chaicharn Pothirat, James W. Dodd, Joerg D. Leuppi, RS: NUTRIM - R3 - Respiratory & Age-related Health, Pulmonologie, Afdeling Onderwijs FHML, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, Promovendi NTM, MUMC+: MA Longziekten (3), [Smid, Dionne E.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Franssen, Frits M. E.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Groenen, Miriam T. J.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Houben-Wilke, Sarah] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Janssen, Daisy J. A.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Nakken, Nienke] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Vanfleteren, Lowie E. G. W.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Wouters, Emiel F. M.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Spruit, Martijn A.] CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands, [Franssen, Frits M. E.] Maastricht Univ, Med Ctr, Dept Resp Med, Maastricht, Netherlands, [Vanfleteren, Lowie E. G. W.] Maastricht Univ, Med Ctr, Dept Resp Med, Maastricht, Netherlands, [Wouters, Emiel F. M.] Maastricht Univ, Med Ctr, Dept Resp Med, Maastricht, Netherlands, [Gonik, Maria] Biomax Informat AG, Planegg, Germany, [Miravitlles, Marc] Hosp Univ Hebron, CIBER Enfermedades Resp CIBERES, Pneumol Dept Hosp, Barcelona, Spain, [Casanova, Ciro] Hosp Univ NS Candelaria, Pulmonaty Dept, Santa Cruz de Tenerife, Spain, [Casanova, Ciro] Hosp Univ NS Candelaria, Res Unit, Santa Cruz de Tenerife, Spain, [Cosio, Borja G.] Hosp Son Espases IdISPa CIBERES, Dept Resp Med, Islas Baleares, Spain, [de Lucas-Ramos, Pilar] Hosp Gen Univ Gregorio Maranon, Pulm Dept, Madrid, Spain, [Marin, Jose M.] Hosp Univ Miguel Servet, IISAragon, CIBER Enfermedades Resp, Zaragoza, Spain, [Martinez, Cristina] Hosp Univ Cent Asturias, Inst Nacl Silicosis, Pneumol Serv, Oviedo, Spain, [Mir, Isabel] Hosp Gen Univ Gregorio Maranon, Pulm Dept, Madrid, Spain, [Soriano, Joan B.] Univ Autonoma Madrid, Hosp Univ Princesa, Inst Invest, IISP, Madrid, Spain, [de Torres, Juan P.] Clin Univ Navarra, Pulm Dept, Pamplona, Spain, [Agusti, Alvar] Univ Barcelona, Hosp Clin, Resp Inst, Barcelona, Spain, [Agusti, Alvar] CIBERES, Madrid, Spain, [Atalay, Nart B.] TOBB Univ Econ & Technol, Dept Psychol, Ankara, Turkey, [Billington, Julia] Surbiton Hlth Ctr, Cent Surg, Surrey, England, [Boutou, Afroditi K.] G Gennimats Gen Hosp, Intens Care Unit, Thessaloniki, Greece, [Boutou, Afroditi K.] Aristotle Univ Thessaloniki, Resp Failure Unit, Thessaloniki, Greece, [Brighenti-Zogg, Stefanie] Univ Clin Med, Cantonal Hosp Baselland, Liestal, Switzerland, [Durr, Selina] Univ Clin Med, Cantonal Hosp Baselland, Liestal, Switzerland, [Leuppi, Joerg D.] Univ Clin Med, Cantonal Hosp Baselland, Liestal, Switzerland, [Miedinger, David] Univ Clin Med, Cantonal Hosp Baselland, Liestal, Switzerland, [Chaplin, Emma] Univ Hosp Leicester NHS Trust, NIHR Leicester Resp Biomed Res Unit, Ctr Exercise & Rehabil Sci, Leicester, Leics, England, [Singh, Sally] Univ Hosp Leicester NHS Trust, NIHR Leicester Resp Biomed Res Unit, Ctr Exercise & Rehabil Sci, Leicester, Leics, England, [Coster, Samantha] Kings Coll London, Florence Nightingale Fac Nursing & Midwifery, London, England, [Murrells, Trevor J.] Kings Coll London, Florence Nightingale Fac Nursing & Midwifery, London, England, [Norman, Ian J.] Kings Coll London, Florence Nightingale Fac Nursing & Midwifery, London, England, [Dodd, James W.] Univ Bristol, Southmead Hosp Bristol, North Bristol Lung Ctr, Acad Resp Unit, Bristol, Avon, England, [Fernandez-Villar, Alberto] Complexo Hosp Vigo, Inst Invest Biomed Vigo, Serv Neumol, Pontevedra, Spain, [Guimaraes, Miguel] Ctr Hosp Vila Nova Gaia Espinho, Pulmonol Dept, Vila Nova De Gaia, Portugal, [Ladeira, Ines] Ctr Hosp Vila Nova Gaia Espinho, Pulmonol Dept, Vila Nova De Gaia, Portugal, [Hejduk, Karel] Masaryk Univ, Fac Med, Inst Biostat & Analyses, Brno, Czech Republic, [Higgins, Victoria] Adelphi Real World, Bollington, England, [Piercy, James] Adelphi Real World, Bollington, England, [Small, Mark] Adelphi Real World, Bollington, England, [Hopkinson, Nicholas S.] Imperial Coll London, Royal Brompton & Harefield NHS Fdn Trust, NIHR Resp Biomed Res Unit, London, England, [Tanner, Rebecca J.] Imperial Coll London, Royal Brompton & Harefield NHS Fdn Trust, NIHR Resp Biomed Res Unit, London, England, [Horita, Nobuyuki] Yokohama City Univ, Grad Sch Med, Dept Pulmonol, Yokohama, Kanagawa, Japan, [Jehn, Melissa] Charite Univ Med Berlin, Arbeitsbereich Ambulante Pneumol, Berlin, Germany, [Joerres, Rudolf] Inst & Output Clin Occupat & Environm Med, Munich, Germany, [Karch, Annika] Hannover Med Sch, Inst Biostat, Hannover, Germany, [Kelly, Julia L.] Imperial Coll London, NIHR Resp Dis Biomed Res Unit Royal Brompton, Natl Heart & Lung Inst, Acad Unit Sleep & Ventilat, London, England, [Kelly, Julia L.] Harefield NHS Fdn Trust & Imperial Coll, London, England, [Kim, Yu-Il] Chonnam Natl Univ Hosp, Dept Internal Med, Div Pulmonol, Donggu, Gwangju, South Korea, [Kimura, Hiroshi] Nara Med Univ, Dept Internal Med 2, Nara, Japan, [Yoshikawa, Masanori] Nara Med Univ, Dept Internal Med 2, Nara, Japan, [Koblizek, Vladimir] Charles Univ Prague, Fac Med Hradec Kralove, Dept Pneumol, Hradec Kralove, Czech Republic, [Novotna, Barbora] Charles Univ Prague, Fac Med Hradec Kralove, Dept Pneumol, Hradec Kralove, Czech Republic, [Koblizek, Vladimir] Univ Hosp Hradec Kralove, Hradec Kralove, Czech Republic, [Novotna, Barbora] Univ Hosp Hradec Kralove, Hradec Kralove, Czech Republic, [Kocks, Janwillem H.] Univ Groningen, Univ Med Ctr Groningen, Groningen Res Inst Asthma, Dept Primary Care, Groningen, Netherlands, [van der Molen, Thys] Univ Groningen, Univ Med Ctr Groningen, Groningen Res Inst Asthma, Dept Primary Care, Groningen, Netherlands, [Tsiligianni, Ioanna G.] Univ Groningen, Univ Med Ctr Groningen, Groningen Res Inst Asthma, Dept Primary Care, Groningen, Netherlands, [Kocks, Janwillem H.] Univ Groningen, Univ Med Ctr Groningen, GRIAC, COPD, Groningen, Netherlands, [van der Molen, Thys] Univ Groningen, Univ Med Ctr Groningen, GRIAC, COPD, Groningen, Netherlands, [Tsiligianni, Ioanna G.] Univ Groningen, Univ Med Ctr Groningen, GRIAC, COPD, Groningen, Netherlands, [Kon, Samantha S. C.] Hillingdon Hosp NHS Fdn Trust, Uxbridge, Middx, England, [Kon, Samantha S. C.] Royal Brompton & Harefield NHS Fdn Trust, NIHR Resp Biomed Res Unit, London, England, [Man, William D-C] Royal Brompton & Harefield NHS Fdn Trust, NIHR Resp Biomed Res Unit, London, England, [Kon, Samantha S. C.] Imperial Coll, London, England, [Man, William D-C] Imperial Coll, London, England, [Kwon, Namhee] GlaxoSmithICline GSK, Resp Franchise Med, London, England, [Lee, Sang-Do] Univ Ulsan, Coll Med, Clin Res Ctr Chron Obstruct Airway Dis, Asan Med Ctr,Dept Pulm & Critical Care Med, Seoul, South Korea, [Locantore, Nicholas] GlaxoSmithICline, King Of Prussia, PA USA, [Lopez-Campos, Jose L.] Univ Seville, Hosp Univ Virgen Rocio, Inst Biomed Sevilla, Unidad MedQuirarg Enfermedades Resp, Seville, Spain, [Lopez-Campos, Jose L.] Inst Salud Carlos III, CIBERES, CIBER Enfermedades Resp, Madrid, Spain, [Maricic, Lana] Univ JJ Strossmayer Osijek, Fac Med, Dept Internal Med, Univ Hosp Osijek, Osijek, Croatia, [Mendoza, Laura] Hosp Clin Univ Chile, Independencia, Region Metropol, Chile, [Mihaltan, Florin] Inst Pneumol Marius Nasta, Bucharest, Romania, [Minami, Seigo] Osaka Police Hosp, Dept Resp Med, Osaka, Japan, [Nishijima, Yu] Osaka Police Hosp, Dept Resp Med, Osaka, Japan, [Ogata, Yoshitaka] Osaka Police Hosp, Dept Resp Med, Osaka, Japan, [Nishijima, Yu] Osaka Univ, Grad Sch Med, Dept Resp Med Allergy & Rheumat Dis, Suita, Osaka, Japan, [O'Donnell, Denis E.] Queens Univ & Kingston Gen Hosp, Dept Med, Kingston, ON, Canada, [Webb, Katherine A.] Queens Univ & Kingston Gen Hosp, Dept Med, Kingston, ON, Canada, [Pereira, Eanes D.] Fed Univ Ceara Brazil, Fortaleza, Ceara, Brazil, [Price, David] Observat & Pragmat Res Inst, Singapore, Singapore, [Price, David] Univ Aberdeen, Aberdeen, Scotland, [Pothirat, Chaicharn] Chiang Mai Univ, Fac Med, Dept Internal Med, Div Pulm Crit Care & Allergy, Chiang Mai, Thailand, [Raghavan, Natya] McMaster Univ, Dept Med, Hamilton, ON, Canada, [Ringbaek, Thomas] Univ Copenhagen, Hvidovre Hosp, Dept Resp Med, Copenhagen, Denmark, [Sajkov, Dimitar] Flinders Med Ctr, Australian Resp & Sleep Med Inst, Adelaide, SA, Australia, [Sigari, Naseh] Kurdistan Univ Med Sci, Med Fac, Internal Med Dept, Sanandaj, Iran, [da Silva, Guilherme F.] Univ Fortaleza, UNIFOR, Fortaleza, Ceara, Brazil, [Tsiligianni, Ioanna G.] Agia Barbara Hlth Care Ctr, Iraklion, Greece, [Tulek, Baykal] Selcuk Univ, Fac Med, Dept Chest Dis, Konya, Turkey, [Tulek, Baykal] Univ Crete, Med Sch, Univ Hosp Herakl, Dept Thorac Med, Iraklion, Greece, [Watz, Henrik] German Ctr Lung Res, Pulm Res Inst, Lung Clin Grosshansdorf, Grosshansdorf, Germany, [Xie, Guogang G.] Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Resp Med, Shanghai, Peoples R China, [Spruit, Martijn A.] Hasselt Univ, Fac Med & Life Sci, Biomed Res Inst, REVAL,Rehabil Res Ctr,BIOMED, Diepenbeek, Belgium, [Spruit, Martijn A.] Maastricht Univ, Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, Dept Resp Med, Maastricht, Netherlands, MRC, National Institute for Health Research, Medical Research Council, Department of Health, Medical Research Council (MRC), EU/IMI Joint Undertaking, TOBB ETU, Faculty of Science and Literature, Department of Psychology, TOBB ETÜ, Fen Edebiyat Fakültesi, Psikoloji Bölümü, Atalay, Nart Bedin, and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
ASSESSMENT TEST SCORE, Male, clinical significance, health status, HISTORY ASSESSMENT, Global Health, Severity of Illness Index, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Assessment test score, Quality of life, CLINICAL CHARACTERISTICS, QUALITY-OF-LIFE, Sickness Impact Profile, 030212 general & internal medicine, Prospective cohort study, Copd assessment test, General Nursing, POPULATION, COPD, education.field_of_study, HEALTH-STATUS, COPD ASSESSMENT TEST, Evidence-Based Medicine, medicine.diagnostic_test, Health Policy, Age Factors, Cat, CAT, General Medicine, Middle Aged, Obstructive lung disease, Health-status, 3. Good health, 1117 Public Health And Health Services, Practice Guidelines as Topic, Disease Progression, Female, Symptom Assessment, Research-council scale, Spirometry, medicine.medical_specialty, Population, Risk Assessment, 03 medical and health sciences, Sex Factors, Internal medicine, Severity of illness, medicine, Humans, GOLD, education, Aged, Receiver operating characteristic, Clinical characteristics, business.industry, 1103 Clinical Sciences, medicine.disease, RESEARCH-COUNCIL SCALE, History assessment, PHYSICAL-ACTIVITY, 030228 respiratory system, Geriatrics, Physical therapy, Physical-activity, Quality-of-life, Geriatrics and Gerontology, business
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. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Published
2017

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