Observational studyInternational journal of chronic obstructive pulmonary disease2015
Application of the new GOLD COPD staging system to a US primary care cohort, with comparison to physician and patient impressions of severity.
Observational study in International journal of chronic obstructive pulmonary disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Investigating the comorbidity of COPD and tuberculosis, a computational study.Frontiers in systems biology · 2023Article
- Article
- Impact of Positive Airway Pressure Therapy Adherence on Outcomes in Patients with Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2022Observational
- How to Utilize CAT and mMRC Scores to Assess Symptom Status of Patients with COPD in Clinical Practice?Medeniyet medical journal · 2022Article
- Review
- What matters to people with COPD: outputs from Working Together for Change.NPJ primary care respiratory medicine · 2019Article
- Health Care Resource Utilization and Exacerbation Rates in Patients with COPD Stratified by Disease Severity in a Commercially Insured Population.Journal of managed care & specialty pharmacy · 2019Article
- A Cross-Sectional Study in Patients with Severe COPD to Assess the Perception of Symptom Variability (COPVAR) in the Middle East and Africa.International journal of chronic obstructive pulmonary disease · 2019Observational
- Impact of using the new GOLD classification on the distribution of COPD severity in clinical practice.International journal of chronic obstructive pulmonary disease · 2018Observational
- Sociodemographic and clinical factors affecting the quality of life of patients with chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2018Observational
- Life Impact and Treatment Preferences of Individuals with Asthma and Chronic Obstructive Pulmonary Disease: Results from Qualitative Interviews and Focus Groups.Advances in therapy · 2017Article
- Relationship between Fractional Exhaled Nitric Oxide Level and Efficacy of Inhaled Corticosteroid in Asthma-COPD Overlap Syndrome Patients with Different Disease Severity.Journal of Korean medical science · 2017Article
- New combined assessment of chronic obstructive pulmonary disease: Utilization, pitfalls, and association with spirometry.Lung India : official organ of Indian Chest SocietyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2011, the traditional Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD spirometry-based severity classification system was revised to also include exacerbation history and COPD Assessment Test (CAT) and modified Medical Research Council Dyspnea Scale (mMRC) scores. This study examined how COPD patients treated in primary care are reclassified by the new GOLD system compared to the traditional system, and each system's level of agreement with patient's or physician's severity assessments.
methodsIn this US multicenter cross-sectional study, COPD patients were recruited by 83 primary care practitioners (PCPs) to complete spirometry testing and a survey. Patients were classified by the traditional spirometry-based system (stages 1-4) and under the new system (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. Concordance between physician and patient-reported severity, spirometry stage, and ABCD grade based on either mMRC or CAT scores was examined.
resultsData from 445 patients with spirometry-confirmed COPD were used. As compared to the traditional system, the GOLD mMRC system reclassifies 47% of patients, and GOLD CAT system reclassifies 41%, but the distributions are very different. The GOLD mMRC system resulted in relatively equal distributions by ABCD grade (33%, 22%, 19%, 26%, respectively), but the GOLD CAT system put most into either B or D groups (9%, 45%, 4%, and 42%). The addition of exacerbation history reclassified only 19 additional patients. Agreement between PCPs' severity rating or their patients' self-assessment and the new ABCD grade was very poor (κ=0.17 or less).
conclusionAs compared to the traditional system, the GOLD 2011 multidimensional system reclassified nearly half of patients, but how they were reclassified varied greatly by whether the mMRC or CAT questionnaire was chosen. Either way, the new system had little correlation with the PCPs or their patients' impressions about the COPD severity.
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