Miravitlles, MarcHuerta, AliciaFernández-Villar, José AlbertoAlcázar, BernardinoVilla, GuillermoForné, CarlesCuesta, MaribelCrespo, CarlosGarcía-Río, Francisco2016-07-272016-07-272014Miravitlles M, Huerta A, Fernández-Villar JA, Alcázar B, Villa G, Forné C, et al. Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. Health Qual Life Outcomes. 2014; 12:120http://hdl.handle.net/10668/2283Journal Article; Observational Study; Research Support, Non-U.S. Gov't;BACKGROUND To determine generic utilities for Spanish chronic obstructive pulmonary disease (COPD) patients stratified by different classifications: GOLD 2007, GOLD 2013, GesEPOC 2012 and BODEx index. METHODS Multicentre, observational, cross-sectional study. Patients were aged ≥40 years, with spirometrically confirmed COPD. Utility values were derived from EQ-5D-3 L. Means, standard deviations (SD), medians and interquartile ranges (IQR) were computed based on the different classifications. Differences in median utilities between groups were assessed by non-parametric tests. RESULTS 346 patients were included, of which 85.5% were male with a mean age of 67.9 (SD = 9.7) years and a mean duration of COPD of 7.6 (SD = 5.8) years; 80.3% were ex-smokers and the mean smoking history was 54.2 (SD = 33.2) pack-years. Median utilities (IQR) by GOLD 2007 were 0.87 (0.22) for moderate; 0.80 (0.26) for severe and 0.67 (0.42) for very-severe patients (p < 0.001 for all comparisons). Median utilities by GOLD 2013 were group A: 1.0 (0.09); group B: 0.87 (0.13); group C: 1.0 (0.16); group D: 0.74 (0.29); comparisons were statistically significant (p < 0.001) except A vs C. Median utilities by GesEPOC phenotypes were 0.84 (0.33) for non exacerbator; 0.80 (0.26) for COPD-asthma overlap; 0.71 (0.62) for exacerbator with emphysema; 0.72 (0.57) for exacerbator with chronic bronchitis (p < 0.001). Comparisons between patients with or without exacerbations and between patients with COPD-asthma overlap and exacerbator with chronic bronchitis were statistically-significant (p < 0.001). Median utilities by BODEx index were: group 0-2: 0.89 (0.20); group 3-4: 0.80 (0.27); group 5-6: 0.67 (0.29); group 7-9: 0.41 (0.31). All comparisons were significant (p < 0.001) except between groups 3-4 and 5-6. CONCLUSION Irrespective of the classification used utilities were associated to disease severity. Some clinical phenotypes were associated with worse utilities, probably related to a higher frequency of exacerbations. GOLD 2007 guidelines and BODEx index better discriminated patients with a worse health status than GOLD 2013 guidelines, while GOLD 2013 guidelines were better able to identify a smaller group of patients with the best health.enChronic obstructive pulmonary diseaseHealth utilityHealth related quality of lifeGOLDGesEPOCEnfermedad pulmonar obstructiva crónicaCalidad de vidaSaludAsmaAnsiedadMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::AgedMedical Subject Headings::Information Science::Information Science::Computing Methodologies::AlgorithmsMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Emotions::AnxietyMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::AsthmaMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional StudiesMedical Subject Headings::Anatomy::Urogenital System::Genitalia::Genitalia, FemaleMedical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Health Status::Health Status DisparitiesMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Anatomy::Urogenital System::Genitalia::Genitalia, MaleMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Mobility LimitationMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor ActivityMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::PainMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic ObstructiveMedical Subject Headings::Disciplines and Occupations::Social Sciences::Quality of LifeMedical Subject Headings::Geographicals::Geographic Locations::Europe::SpainMedical Subject Headings::Information Science::Information Science::Data Collection::QuestionnairesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Rehabilitation::Activities of Daily Livingresearch article25189786open access10.1186/s12955-014-0120-51477-7525PMC4173058