Citation: International Journal of Copd. 9:991-8, 2014..Journal: International journal of chronic obstructive pulmonary disease.ISSN: 1176-9106.Full author list: Solem CT; Sun SX; Liu S; Macahilig C; Katyal M; Gao X; Shorr AF.UI/PMID: 25284999.Subject(s): Aged | Disease Progression | Female | Forced Expiratory Volume | *Health Status | Health Surveys | Humans | *Lung/pp [Physiopathology] | Male | Middle Aged | Predictive Value of Tests | Pulmonary Disease, Chronic Obstructive/co [Complications] | *Pulmonary Disease, Chronic Obstructive/di [Diagnosis] | Pulmonary Disease, Chronic Obstructive/pp [Physiopathology] | *Questionnaires | Risk Assessment | Risk Factors | Severity of Illness Index | *SpirometryInstitution(s): MedStar Washington Hospital CenterDepartment(s): Medicine/Pulmonary-Critical CareActivity type: Journal Article.Online resources: Click here to access onlineDigital Object Identifier: http://dx.doi.org/10.2147/COPD.S66798 (Click here)Abbreviated citation: Int J Chron Obstruct Pulmon Dis. 9:991-8, 2014.Abstract: OBJECTIVE: This study aimed to compare spirometry- and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George's Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C).Abstract: MATERIALS AND METHODS: In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV1] >50%; severe, 30% < FEV1 <50%; very severe, FEV1 <30% predicted), and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/more symptoms) severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems.Abstract: RESULTS: Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV1 <50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D). Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not.Abstract: CONCLUSION: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry.