%0 Journal Article
%A Smid, Dionne E.
%A Franssen, Frits M. E.
%A Gonik, Maria
%A Miravitlles, Marc
%A Casanova, Ciro
%A Cosio, Borja G.
%A de Lucas-Ramos, Pilar
%A Marin, Jose M.
%A Martinez, Cristina
%A Mir, Isabel
%A Soriano, Joan B.
%A de Torres, Juan P.
%A Agusti, Alvar
%A Atalay, Nart B.
%A Billington, Julia
%A Boutou, Afroditi K.
%A Brighenti-Zogg, Stefanie
%A Chaplin, Emma
%A Coster, Samantha
%A Dodd, James W.
%A Durr, Selina
%A Fernandez-Villar, Alberto
%A Groenen, Miriam T. J.
%A Guimaraes, Miguel
%A Hejduk, Karel
%A Higgins, Victoria
%A Hopkinson, Nicholas S.
%A Horita, Nobuyuki
%A Houben-Wilke, Sarah
%A Janssen, Daisy J. A.
%A Jehn, Melissa
%A Joerres, Rudolf
%A Karch, Annika
%A Kelly, Julia L.
%A Kim, Yu-Il
%A Kimura, Hiroshi
%A Koblizek, Vladimir
%A Kocks, Janwillem H.
%A Kon, Samantha S. C.
%A Kwon, Namhee
%A Ladeira, Ines
%A Lee, Sang-Do
%A Leuppi, Joerg D.
%A Locantore, Nicholas
%A Lopez-Campos, Jose L.
%A Man, William D-C
%A Maricic, Lana
%A Mendoza, Laura
%A Miedinger, David
%A Mihaltan, Florin
%A Minami, Seigo
%A van der Molen, Thys
%A Murrells, Trevor J.
%A Nakken, Nienke
%A Nishijima, Yu
%A Norman, Ian J.
%A Novotna, Barbora
%A O'Donnell, Denis E.
%A Ogata, Yoshitaka
%A Pereira, Eanes D.
%A Piercy, James
%A Price, David
%A Pothirat, Chaicharn
%A Raghavan, Natya
%A Ringbaek, Thomas
%A Sajkov, Dimitar
%A Sigari, Naseh
%A Singh, Sally
%A Small, Mark
%A da Silva, Guilherme F.
%A Tanner, Rebecca J.
%A Tsiligianni, Ioanna G.
%A Tulek, Baykal
%A Tzanakis, Nikolaos
%A Vanfleteren, Lowie E. G. W.
%A Watz, Henrik
%A Webb, Katherine A.
%A Wouters, Emiel F. M.
%A Xie, Guogang G.
%A Yoshikawa, Masanori
%A Spruit, Martijn A.
%T 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
%D 2017
%@ 1525-8610
%U http://hdl.handle.net/10668/18810
%X 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.
%K COPD
%K GOLD
%K health status
%K clinical significance
%K Copd assessment test
%K Quality-of-life
%K Research-council scale
%K Assessment test score
%K Health-status
%K Clinical characteristics
%K History assessment
%K Physical-activity
%K Cat
%K Population
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