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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
Authors: Smid, Dionne E.
Franssen, Frits M. E.
Gonik, Maria
Miravitlles, Marc
Casanova, Ciro
Cosio, Borja G.
de Lucas-Ramos, Pilar
Marin, Jose M.
Martinez, Cristina
Mir, Isabel
Soriano, Joan B.
de Torres, Juan P.
Agusti, Alvar
Atalay, Nart Bedin
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.
Tülek, 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.
Keywords: COPD
health status
clinical significance
Issue Date: 1-Dec-2017
Publisher: Elsevier Science Inc
Source: Smid, D. E., Franssen, F. M., Gonik, M., Miravitlles, M., Casanova, C., Cosio, B. G., ... & Soriano, J. B. (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, 18(12), 1097-e11.
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.
ISSN: 1525-8610
Appears in Collections:Psikoloji Bölümü / Department of Psychology
PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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