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Detecting exacerbations using the Clinical COPD Questionnaire
- Source :
- Health and Quality of Life Outcomes, Health and Quality of Life Outcomes, Vol 8, Iss 1, p 102 (2010)
- Publication Year :
- 2010
-
Abstract
- Background Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment). Little is known whether (low burden) strategies are able to capture these unreported exacerbations. Methods The Clinical COPD Questionnaire (CCQ) is a short questionnaire with great evaluative properties in measuring health status. The current explorative study evaluates the discriminative properties of weekly CCQ assessment in detecting exacerbations. Results In a multicentre prospective cohort study, 121 patients, age 67.4 ± 10.5 years, FEV1 47.7 ± 18.5% pred were followed for 6 weeks by daily diary card recording and weekly CCQ assessment. Weeks were retrospectively labeled as stable or exacerbation (onset) weeks using the Anthonisen symptom diary-card algorithm. Change in CCQ total scores are significantly higher in exacerbation-onset weeks, 0.35 ± 0.69 compared to -0.04 ± 0.37 in stable weeks (p < 0.001). Performance of the Δ CCQ total score discriminating between stable and exacerbation onset weeks was sufficient (area under the ROC curve 0.75). At a cut off point of 0.2, sensitivity was 62.5 (50.3-73.4), specificity 82.0 (79.3-84.4), and a positive and negative predictive value of 43.5 (35.0-51.0) and 90.8 (87.8-93.5), respectively. Using this cut off point, 22 (out of 38) unreported exacerbations were detected while 39 stable patients would have been false positively 'contacted'. Conclusions Weekly CCQ assessment is a promising, low burden method to detect unreported exacerbations. Further research is needed to validate discriminative performance and practical implications of the CCQ in detecting exacerbations in daily care.
- Subjects :
- Male
medicine.medical_specialty
Canada
Exacerbation
Health Status
lcsh:Computer applications to medicine. Medical informatics
Statistics, Nonparametric
Cohort Studies
Pulmonary Disease, Chronic Obstructive
Quality of life
Internal medicine
Surveys and Questionnaires
medicine
Humans
Prospective Studies
Prospective cohort study
Practical implications
Aged
Health related quality of life
COPD
Receiver operating characteristic
business.industry
Research
Public Health, Environmental and Occupational Health
General Medicine
Middle Aged
medicine.disease
ROC Curve
Physical therapy
Disease Progression
Quality of Life
lcsh:R858-859.7
Female
business
Algorithms
Cohort study
Subjects
Details
- ISSN :
- 14777525
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Health and quality of life outcomes
- Accession number :
- edsair.doi.dedup.....612f492457428cefa16a6661a19bb231