Trial reportBMC pulmonary medicine2014
Does the 2013 GOLD classification improve the ability to predict lung function decline, exacerbations and mortality: a post-hoc analysis of the 4-year UPLIFT trial.
Trial report in BMC pulmonary medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00144339 (A Randomized, Double-blind, Placebo-controlled, Parallel Group Trial Assessing the Rate of Decline of Lung Function With Tiotropium 18 mcg Inhalation Capsule Once Daily in Patients With Chronic Obstructive Pulmonary Disease), which is not on this map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized, Double-blind, Placebo-controlled, Parallel Group Trial Assessing the Rate of Decline of Lung Function With Tiotropium 18 mcg Inhalation Capsule Once Daily in Patients With Chronic Obstructive Pulmonary Disease (COPD).
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review and Quality Appraisal of Cost-Effectiveness Analyses of Pharmacologic Maintenance Treatment for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Recommendations.PharmacoEconomics · 2017Pooled it
- Trial
- Differences in outcomes between GOLD groups in patients with COPD in the TIOSPIR(®) trial.International journal of chronic obstructive pulmonary disease · 2016Trial
- Rectifying COPD management: a critical analysis of the Global Initiative for Chronic Obstructive Lung Disease strategy.ERJ open research · 2026Review
- Prognostic Models for Disease Progression and Outcomes in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Acknowledging the syndemic: a real-life cohort study of major adverse cardiovascular events in COPD.ERJ open research · 2025Article
- Clinically important deterioration in a mild-moderate COPD population.ERJ open research · 2025Article
- Fractional Dynamics Foster Deep Learning of COPD Stage Prediction.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Severity distribution and treatment of chronic obstructive pulmonary disease in China: baseline results of an observational study.Respiratory research · 2022Observational
- Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data.ERJ open research · 2020Article
- Validity of EQ-5D utility index and minimal clinically important difference estimation among patients with chronic obstructive pulmonary disease.BMC pulmonary medicine · 2020Article
- Variation in Assignment of the COPD Patients into a GOLD Group According to Symptoms Severity.International journal of chronic obstructive pulmonary disease · 2020Observational
- FEVInternational journal of chronic obstructive pulmonary disease · 2020Article
- Pulmonary Subtypes Exhibit Differential Global Initiative for Chronic Obstructive Lung Disease Spirometry Stage Progression: The COPDGene® Study.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2019Article
- Classification and treatment of chronic obstructive pulmonary disease outpatients in China according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017: comparison with GOLD 2014.Journal of thoracic disease · 2019Article
- COPD: The Annual Cost-Of-Illness during the Last Two Decades in Italy, and Its Mortality Predictivity Power.Healthcare (Basel, Switzerland) · 2019Review
- Mortality and Exacerbations by Global Initiative for Chronic Obstructive Lung Disease Groups ABCD: 2011 Versus 2017 in the COPDGene® Cohort.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2019Article
- Prevalence and prognostic ability of the GOLD 2017 classification compared to the GOLD 2011 classification in a Norwegian COPD cohort.International journal of chronic obstructive pulmonary disease · 2019Article
- The Comparison of Clinical Variables in Two Classifications: GOLD 2017 Combined Assessment and Spirometric Stage of Chronic Obstructive Pulmonary Disease.Tuberculosis and respiratory diseases · 2018Article
- Predictors of short-term LAMA ineffectiveness in treatment naïve patients with moderate to severe COPD.Wiener klinische Wochenschrift · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2013 GOLD classification system for COPD distinguishes four stages: A (low symptoms, low exacerbation risk), B (high symptoms, low risk), C (low symptoms, high risk) and D (high symptoms, high risk). Assessment of risk is based on exacerbation history and airflow obstruction, whatever results in a higher risk grouping. The previous system was solely based on airflow obstruction. Earlier studies compared the predictive performance of new and old classification systems with regards to mortality and exacerbations. The objective of this study was to compare the ability of both classifications to predict the number of future (total and severe) exacerbations and mortality in a different patient population, and to add an outcome measure to the comparison: lung function decline.
methodsPatient-level data from the UPLIFT trial were used to analyze 4-year survival in a Weibull model, with GOLD stages at baseline as covariates. A generalized linear model was used to compare the numbers of exacerbations (total and severe) per stage. Analyses were repeated with stages C and D divided into substages depending on lung function and exacerbation history. Lung function decline was analysed in a repeated measures model.
resultsMortality increased from A to D, but there was no difference between B and C. For the previous GOLD stages 2-4, survival curves were clearly separated. Yearly exacerbation rates were: 0.53, 0.72 and 0.80 for stages 2-4; and 0.35, 0.45, 0.58 and 0.74 for A-D. Annual rates of lung function decline were: 47, 38 and 26 ml for stages 2-4 and 44, 48, 38 and 39 for stages A-D. With regards to model fit, the new system performed worse at predicting mortality and lung function decline, and better at predicting exacerbations. Distinguishing between the sub-stages of high-risk led to substantial improvements.
conclusionsThe new classification system is a modest step towards a phenotype approach. It is probably an improvement for the prediction of exacerbations, but a deterioration for predicting mortality and lung function decline.
trial registrationClinicalTrials.gov NCT00144339 (September 2, 2005).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.