Repository of Research and Investigative Information

Repository of Research and Investigative Information

Kurdistan University of Medical Sciences

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

(2017) 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. Journal of the American Medical Directors Association.

Full text not available from this repository.

Official URL: https://www.scopus.com/inward/record.uri?eid=2-s2....

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, postbronchodilator 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. © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine

Item Type: Article
Keywords: bronchodilating agent, adult; age; aged; Article; calibration; chronic obstructive lung disease; disease burden; disease classification; dyspnea; female; forced expiratory volume; human; major clinical study; male; measurement; questionnaire; receiver operating characteristic; sex; spirometry; symptom
Page Range: 1097.e11-1097.e24
Journal or Publication Title: Journal of the American Medical Directors Association
Volume: 18
Number: 12
Publisher: Elsevier Inc.
Identification Number: 10.1016/j.jamda.2017.09.003
ISSN: 15258610
Depositing User: مهندس مهدی شریفی
URI: http://eprints.muk.ac.ir/id/eprint/150

Actions (login required)

View Item View Item