Variation in assignment of the COPD patients into a GOLD group according to symptoms severity

Moya-álvarez, V. ; Quevedo-Marín, J.L. ; Ji, Z. ; Navarro-Jiménez, C. ; Jiménez-García, R. ; López-De-andrés, A. ; Pérez-Trullén, Alfonso (Universidad de Zaragoza) ; de Miguel-Díez, J.

Resumen: Introduction: The Global Organization of Lung Disease (GOLD) classifies patients with chronic obstructive pulmonary disease (COPD) taking into account the symptoms. The modified Medical Research Council’s dyspnea scale (mMRC) and the COPD assessment test (CAT) are used to assess these symptoms. In this study, we analyze the concordance of GOLD classification using mMRC and CAT. Patients and Methods: This is an observational study of a cohort of 169 patients with COPD, who were classified following the GOLD 2017 recommendations, using both mMRC and CAT. A concordance analysis was applied, and a ROC curve was generated to identify the CAT score that best concorded with the mMRC scale. Results: The concordance for the GOLD groups classified by CAT and mMRC was moderate (kappa 0.492). For mMRC score of 1 and 2, a CAT score of =9 and =16 showed the maximum value of the Youden index, respectively. By reclassifying the patients with the new cut-off points obtained, the best concordance was obtained between the cut-off point for CAT of 16 and for mMRC of 2, followed by CAT of 9 and mMRC of 1. Conclusion: Because of the deficient concordance between CAT and mMRC, we propose the use of new cut-off points in future updates of the GOLD strategy.

Idioma: Inglés

DOI: 10.2147/COPD.S253445

Año: 2020

Publicado en: International journal of chronic obstructive pulmonary disease 15 (2020), 1987-1995
ISSN: 1176-9106

Factor impacto JCR: 3.355 (2020)

Categ. JCR: RESPIRATORY SYSTEM rank: 30 / 64 = 0.469 (2020) - Q2 - T2

Factor impacto SCIMAGO: 1.393 - Health Policy (Q1) - Pulmonary and Respiratory Medicine (Q1) - Public Health, Environmental and Occupational Health (Q1) - Medicine (miscellaneous) (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)