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 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

SMID, D.E., F.M.E. FRANSSEN, M. GONIK, M. MIRAVITLLES, C. CASANOVA et. al.

Basic information

Original name

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, D.E. (528 Netherlands), F.M.E. FRANSSEN (528 Netherlands), M. GONIK (276 Germany), M. MIRAVITLLES (724 Spain), C. CASANOVA (724 Spain), B.G. COSIO (724 Spain), P. de LUCAS-RAMOS (724 Spain), J.M. MARIN (724 Spain), C. MARTINEZ (724 Spain), I. MIR (724 Spain), J.B. SORIANO (724 Spain), J.P. de TORRES (724 Spain), A. AGUSTI (724 Spain), N.B. ATALAY (792 Turkey), J. BILLINGTON (826 United Kingdom of Great Britain and Northern Ireland), A.K. BOUTOU (300 Greece), S. BRIGHENTI-ZOGG (756 Switzerland), E. CHAPLIN (826 United Kingdom of Great Britain and Northern Ireland), S. COSTER (826 United Kingdom of Great Britain and Northern Ireland), J.W. DODD (826 United Kingdom of Great Britain and Northern Ireland), S. DURR (756 Switzerland), A. FERNANDEZ-VILLAR (724 Spain), M.T.J. GROENEN (528 Netherlands), M. GUIMARAES (620 Portugal), Karel HEJDUK (203 Czech Republic, guarantor, belonging to the institution), V. HIGGINS (826 United Kingdom of Great Britain and Northern Ireland), N.S. HOPKINSON (826 United Kingdom of Great Britain and Northern Ireland), N. HORITA (392 Japan), S. HOUBEN-WILKE (528 Netherlands), D.J.A. JANSSEN (528 Netherlands), M. JEHN (276 Germany), R. JOERRES (276 Germany), A. KARCH (276 Germany), J.L. KELLY (826 United Kingdom of Great Britain and Northern Ireland), Y.I. KIM (410 Republic of Korea), H. KIMURA (392 Japan), V. KOBLIZEK (203 Czech Republic), J.H. KOCKS (528 Netherlands), S.S.C. KON (826 United Kingdom of Great Britain and Northern Ireland), N. KWON (826 United Kingdom of Great Britain and Northern Ireland), I. LADEIRA (620 Portugal), S.D. LEE (410 Republic of Korea), J.D. LEUPPI (756 Switzerland), N. LOCANTORE (840 United States of America), J.L. LOPEZ-CAMPOS (724 Spain), W.D.C. MAN (826 United Kingdom of Great Britain and Northern Ireland), L. MARICIC (191 Croatia), L. MENDOZA (152 Chile), D. MIEDINGER (756 Switzerland), F. MIHALTAN (642 Romania), S. MINAMI (392 Japan), T. van der MOLEN (528 Netherlands), T.J. MURRELLS (826 United Kingdom of Great Britain and Northern Ireland), N. NAKKEN (528 Netherlands), Y. NISHIJIMA (392 Japan), I.J. NORMAN (826 United Kingdom of Great Britain and Northern Ireland), B. NOVOTNA (203 Czech Republic), D.E. O DONNELL (124 Canada), Y. OGATA (392 Japan), E.D. PEREIRA (76 Brazil), J. PIERCY (826 United Kingdom of Great Britain and Northern Ireland), D. PRICE (826 United Kingdom of Great Britain and Northern Ireland), C. POTHIRAT (764 Thailand), N. RAGHAVAN (124 Canada), T. RINGBAEK (208 Denmark), D. SAJKOV (36 Australia), N. SIGARI (368 Iraq), S. SINGH (826 United Kingdom of Great Britain and Northern Ireland), M. SMALL (826 United Kingdom of Great Britain and Northern Ireland), G.F. DA SILVA (76 Brazil), R.J. TANNER (826 United Kingdom of Great Britain and Northern Ireland), I.G. TSILIGIANNI (528 Netherlands), B. TULEK (300 Greece), N. TZANAKIS (528 Netherlands), L.E.G.W. VANFLETEREN (528 Netherlands), H. WATZ (528 Netherlands), K.A. WEBB (124 Canada), E.F.M. WOUTERS (528 Netherlands), G.G. XIE (156 China), M. YOSHIKAWA (392 Japan) and M.A. SPRUIT (528 Netherlands)

Edition

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, NEW YORK, ELSEVIER SCIENCE INC, 2017, 1525-8610

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30227 Geriatrics and gerontology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 5.325

RIV identification code

RIV/00216224:14110/17:00099170

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.jamda.2017.09.003

UT WoS

000416478400025

Keywords in English

COPD; GOLD; health status; clinical significance

Abstract

V originále

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.

Citovat

SMID, D.E., F.M.E. FRANSSEN, M. GONIK, M. MIRAVITLLES, C. CASANOVA, B.G. COSIO, P. de LUCAS-RAMOS, J.M. MARIN, C. MARTINEZ, I. MIR, J.B. SORIANO, J.P. de TORRES, A. AGUSTI, N.B. ATALAY, J. BILLINGTON, A.K. BOUTOU, S. BRIGHENTI-ZOGG, E. CHAPLIN, S. COSTER, J.W. DODD, S. DURR, A. FERNANDEZ-VILLAR, M.T.J. GROENEN, M. GUIMARAES, Karel HEJDUK, V. HIGGINS, N.S. HOPKINSON, N. HORITA, S. HOUBEN-WILKE, D.J.A. JANSSEN, M. JEHN, R. JOERRES, A. KARCH, J.L. KELLY, Y.I. KIM, H. KIMURA, V. KOBLIZEK, J.H. KOCKS, S.S.C. KON, N. KWON, I. LADEIRA, S.D. LEE, J.D. LEUPPI, N. LOCANTORE, J.L. LOPEZ-CAMPOS, W.D.C. MAN, L. MARICIC, L. MENDOZA, D. MIEDINGER, F. MIHALTAN, S. MINAMI, T. van der MOLEN, T.J. MURRELLS, N. NAKKEN, Y. NISHIJIMA, I.J. NORMAN, B. NOVOTNA, D.E. O DONNELL, Y. OGATA, E.D. PEREIRA, J. PIERCY, D. PRICE, C. POTHIRAT, N. RAGHAVAN, T. RINGBAEK, D. SAJKOV, N. SIGARI, S. SINGH, M. SMALL, G.F. DA SILVA, R.J. TANNER, I.G. TSILIGIANNI, B. TULEK, N. TZANAKIS, L.E.G.W. VANFLETEREN, H. WATZ, K.A. WEBB, E.F.M. WOUTERS, G.G. XIE, M. YOSHIKAWA and M.A. SPRUIT. 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. NEW YORK: ELSEVIER SCIENCE INC, 2017, vol. 18, No 12, p. 1-14. ISSN 1525-8610. Available from: https://dx.doi.org/10.1016/j.jamda.2017.09.003.

@article{1402050,
   author = {Smid, D.E. and Franssen, F.M.E. and Gonik, M. and Miravitlles, M. and Casanova, C. and Cosio, B.G. and LucasandRamos, P. de and Marin, J.M. and Martinez, C. and Mir, I. and Soriano, J.B. and Torres, J.P. de and Agusti, A. and Atalay, N.B. and Billington, J. and Boutou, A.K. and BrighentiandZogg, S. and Chaplin, E. and Coster, S. and Dodd, J.W. and Durr, S. and FernandezandVillar, A. and Groenen, M.T.J. and Guimaraes, M. and Hejduk, Karel and Higgins, V. and Hopkinson, N.S. and Horita, N. and HoubenandWilke, S. and Janssen, D.J.A. and Jehn, M. and Joerres, R. and Karch, A. and Kelly, J.L. and Kim, Y.I. and Kimura, H. and Koblizek, V. and Kocks, J.H. and Kon, S.S.C. and Kwon, N. and Ladeira, I. and Lee, S.D. and Leuppi, J.D. and Locantore, N. and LopezandCampos, J.L. and Man, W.D.C. and Maricic, L. and Mendoza, L. and Miedinger, D. and Mihaltan, F. and Minami, S. and Molen, T. van der and Murrells, T.J. and Nakken, N. and Nishijima, Y. and Norman, I.J. and Novotna, B. and O Donnell, D.E. and Ogata, Y. and Pereira, E.D. and Piercy, J. and Price, D. and Pothirat, C. and Raghavan, N. and Ringbaek, T. and Sajkov, D. and Sigari, N. and Singh, S. and Small, M. and da Silva, G.F. and Tanner, R.J. and Tsiligianni, I.G. and Tulek, B. and Tzanakis, N. and Vanfleteren, L.E.G.W. and Watz, H. and Webb, K.A. and Wouters, E.F.M. and Xie, G.G. and Yoshikawa, M. and Spruit, M.A.},
   article_location = {NEW YORK},
   article_number = {12},
   doi = {http://dx.doi.org/10.1016/j.jamda.2017.09.003},
   keywords = {COPD; GOLD; health status; clinical significance},
   language = {eng},
   issn = {1525-8610},
   journal = {JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION},
   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},
   volume = {18},
   year = {2017}
}

TY  - JOUR
ID  - 1402050
AU  - Smid, D.E. - Franssen, F.M.E. - Gonik, M. - Miravitlles, M. - Casanova, C. - Cosio, B.G. - Lucas-Ramos, P. de - Marin, J.M. - Martinez, C. - Mir, I. - Soriano, J.B. - Torres, J.P. de - Agusti, A. - Atalay, N.B. - Billington, J. - Boutou, A.K. - Brighenti-Zogg, S. - Chaplin, E. - Coster, S. - Dodd, J.W. - Durr, S. - Fernandez-Villar, A. - Groenen, M.T.J. - Guimaraes, M. - Hejduk, Karel - Higgins, V. - Hopkinson, N.S. - Horita, N. - Houben-Wilke, S. - Janssen, D.J.A. - Jehn, M. - Joerres, R. - Karch, A. - Kelly, J.L. - Kim, Y.I. - Kimura, H. - Koblizek, V. - Kocks, J.H. - Kon, S.S.C. - Kwon, N. - Ladeira, I. - Lee, S.D. - Leuppi, J.D. - Locantore, N. - Lopez-Campos, J.L. - Man, W.D.C. - Maricic, L. - Mendoza, L. - Miedinger, D. - Mihaltan, F. - Minami, S. - Molen, T. van der - Murrells, T.J. - Nakken, N. - Nishijima, Y. - Norman, I.J. - Novotna, B. - O Donnell, D.E. - Ogata, Y. - Pereira, E.D. - Piercy, J. - Price, D. - Pothirat, C. - Raghavan, N. - Ringbaek, T. - Sajkov, D. - Sigari, N. - Singh, S. - Small, M. - da Silva, G.F. - Tanner, R.J. - Tsiligianni, I.G. - Tulek, B. - Tzanakis, N. - Vanfleteren, L.E.G.W. - Watz, H. - Webb, K.A. - Wouters, E.F.M. - Xie, G.G. - Yoshikawa, M. - Spruit, M.A.
PY  - 2017
TI  - 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
JF  - JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
VL  - 18
IS  - 12
SP  - 1-14
EP  - 1-14
PB  - ELSEVIER SCIENCE INC
SN  - 15258610
KW  - COPD
KW  - GOLD
KW  - health status
KW  - clinical significance
N2  - 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.
ER  -

SMID, D.E., F.M.E. FRANSSEN, M. GONIK, M. MIRAVITLLES, C. CASANOVA, B.G. COSIO, P. de LUCAS-RAMOS, J.M. MARIN, C. MARTINEZ, I. MIR, J.B. SORIANO, J.P. de TORRES, A. AGUSTI, N.B. ATALAY, J. BILLINGTON, A.K. BOUTOU, S. BRIGHENTI-ZOGG, E. CHAPLIN, S. COSTER, J.W. DODD, S. DURR, A. FERNANDEZ-VILLAR, M.T.J. GROENEN, M. GUIMARAES, Karel HEJDUK, V. HIGGINS, N.S. HOPKINSON, N. HORITA, S. HOUBEN-WILKE, D.J.A. JANSSEN, M. JEHN, R. JOERRES, A. KARCH, J.L. KELLY, Y.I. KIM, H. KIMURA, V. KOBLIZEK, J.H. KOCKS, S.S.C. KON, N. KWON, I. LADEIRA, S.D. LEE, J.D. LEUPPI, N. LOCANTORE, J.L. LOPEZ-CAMPOS, W.D.C. MAN, L. MARICIC, L. MENDOZA, D. MIEDINGER, F. MIHALTAN, S. MINAMI, T. van der MOLEN, T.J. MURRELLS, N. NAKKEN, Y. NISHIJIMA, I.J. NORMAN, B. NOVOTNA, D.E. O DONNELL, Y. OGATA, E.D. PEREIRA, J. PIERCY, D. PRICE, C. POTHIRAT, N. RAGHAVAN, T. RINGBAEK, D. SAJKOV, N. SIGARI, S. SINGH, M. SMALL, G.F. DA SILVA, R.J. TANNER, I.G. TSILIGIANNI, B. TULEK, N. TZANAKIS, L.E.G.W. VANFLETEREN, H. WATZ, K.A. WEBB, E.F.M. WOUTERS, G.G. XIE, M. YOSHIKAWA and M.A. SPRUIT. 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. \textit{JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION}. NEW YORK: ELSEVIER SCIENCE INC, 2017, vol.~18, No~12, p.~1-14. ISSN~1525-8610. Available from: https://dx.doi.org/10.1016/j.jamda.2017.09.003.

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