ArticleRespirology (Carlton, Vic.)2026
Can Patient Education Lead the Way? Head-To-Head Comparison of EXACT and CERT for Early Recognition of Acute COPD Exacerbations.
Article in Respirology (Carlton, Vic.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04140097 (Predictors of Acute Exacerbation in Patients With COPD - an Observational Study), which is not on this map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Predictors of Acute Exacerbation in Patients With COPD - an Observational Study (PACE Trial)
Who cites it
3 citing papers in PubMed.
- Timely management of COPD exacerbations is associated with limited acute deterioration and early recovery: a prospective observational study.Respiratory research · 2026Observational
- COPD Exacerbation Recognition Tool: Translation, Linguistic, and Cross-Cultural Validation.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026Article
- Can Patient Education Lead the Way? Head-To-Head Comparison of EXACT and CERT for Early Recognition of Acute COPD Exacerbations.Respirology (Carlton, Vic.) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
BACKGROUND AND
objectiveAcute exacerbations of COPD (AECOPD) worsen outcomes, yet they are often underreported. The 14-item EXACT diary has been validated for trial use-the five-item CERT checklist is patient-centered. We compared the two tools' accuracy and early-warning performance for AECOPD.
methodsThis prospective study examined 63 COPD patients who completed EXACT and CERT daily. Two metrics were used for CERT: total score and binary (positive if ≥ 2 items were rated as moderate/severe). AECOPD patients were bootstrap matched to a non-exacerbator. Linear mixed-effects models assessed score differences on the day of AECOPD diagnosis and the previous days.
resultsTwelve patients developed clinically confirmed AECOPD. On the day of AECOPD diagnosis, all tools discriminated AECOPD (AUC: EXACT 0.90, CERT total score 0.88, and CERT binary 0.87; p < 0.01). At optimal thresholds, sensitivities ranged from 81% to 87%, and specificities ranged from 93% to 95%. One day before the AECOPD diagnosis, the CERT total score (5.9 vs. 1.4; p = 0.006) and the CERT binary outcome (70.4% vs. 9.3%; p = 0.009) significantly distinguished impending exacerbations. However, the EXACT score did not (39.6% vs. 34.3%; p = 0.186). The CERT total score yielded an AUC of 0.86 (sensitivity 83%, specificity 86%), and the binary rating achieved a specificity of 91% and a sensitivity of 70% one day before diagnosis.
conclusionBoth EXACT and CERT can accurately detect AECOPD at the time of diagnosis. However, patients were able to recognise worsening symptoms one day before an AECOPD diagnosis when using the CERT.
trial registrationclinicaltrials.gov (NCT04140097).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.