RT Journal Article
T1 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
A1 Smid, Dionne E.
A1 Franssen, Frits M. E.
A1 Gonik, Maria
A1 Miravitlles, Marc
A1 Casanova, Ciro
A1 Cosio, Borja G.
A1 de-Lucas-Ramos, Pilar
A1 Marin, Jose M.
A1 Martinez, Cristina
A1 Mir, Isabel
A1 Soriano, Joan B.
A1 de-Torres, Juan P.
A1 Agusti, Alvar
A1 Atalay, Nart B.
A1 Billington, Julia
A1 Boutou, Afroditi K.
A1 Brighenti-Zogg, Stefanie
A1 Chaplin, Emma
A1 Coster, Samantha
A1 Dodd, James W.
A1 Durr, Selina
A1 Fernandez-Villar, Alberto
A1 Groenen, Miriam T. J.
A1 Guimaraes, Miguel
A1 Hejduk, Karel
A1 Higgins, Victoria
A1 Hopkinson, Nicholas S.
A1 Horita, Nobuyuki
A1 Houben-Wilke, Sarah
A1 Janssen, Daisy J. A.
A1 Jehn, Melissa
A1 Joerres, Rudolf
A1 Karch, Annika
A1 Kelly, Julia L.
A1 Kim, Yu-Il
A1 Kimura, Hiroshi
A1 Koblizek, Vladimir
A1 Kocks, Janwillem H.
A1 Kon, Samantha S. C.
A1 Kwon, Namhee
A1 Ladeira, Ines
A1 Lee, Sang-Do
A1 Leuppi, Joerg D.
A1 Locantore, Nicholas
A1 Lopez-Campos, Jose L.
A1 Man, William D-C
A1 Maricic, Lana
A1 Mendoza, Laura
A1 Miedinger, David
A1 Mihaltan, Florin
A1 Minami, Seigo
A1 van-der-Molen, Thys
A1 Murrells, Trevor J.
A1 Nakken, Nienke
A1 Nishijima, Yu
A1 Norman, Ian J.
A1 Novotna, Barbora
A1 O'Donnell, Denis E.
A1 Ogata, Yoshitaka
A1 Pereira, Eanes D.
A1 Piercy, James
A1 Price, David
A1 Pothirat, Chaicharn
A1 Raghavan, Natya
A1 Ringbaek, Thomas
A1 Sajkov, Dimitar
A1 Sigari, Naseh
A1 Singh, Sally
A1 Small, Mark
A1 da-Silva, Guilherme F.
A1 Tanner, Rebecca J.
A1 Tsiligianni, Ioanna G.
A1 Tulek, Baykal
A1 Tzanakis, Nikolaos
A1 Vanfleteren, Lowie E. G. W.
A1 Watz, Henrik
A1 Webb, Katherine A.
A1 Wouters, Emiel F. M.
A1 Xie, Guogang G.
A1 Yoshikawa, Masanori
A1 Spruit, Martijn A.
K1 COPD
K1 GOLD
K1 health status
K1 clinical significance
K1 Copd assessment test
K1 Quality-of-life
K1 Research-council scale
K1 Assessment test score
K1 Health-status
K1 Clinical characteristics
K1 History assessment
K1 Physical-activity
K1 Cat
K1 Population
AB 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.
PB Elsevier science inc
SN 1525-8610
YR 2017
FD 2017
LK http://hdl.handle.net/10668/18810
UL http://hdl.handle.net/10668/18810
LA en
NO Smid DE, Franssen FME, Gonik M, Miravitlles M, Casanova C, Cosio BG, et al. 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 Am Med Dir Assoc. 2017 Dec 1;18(12):1097.e11-1097.e24.
DS RISalud
RD Jul 5, 2025