TY  - BOOK
AU  - Shorr, Andrew F
TI  - Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey
SN  - 1176-9106
PY  - 2014///
KW  - *Health Status
KW  - *Lung/pp [Physiopathology]
KW  - *Pulmonary Disease, Chronic Obstructive/di [Diagnosis]
KW  - *Questionnaires
KW  - *Spirometry
KW  - Aged
KW  - Disease Progression
KW  - Female
KW  - Forced Expiratory Volume
KW  - Health Surveys
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Predictive Value of Tests
KW  - Pulmonary Disease, Chronic Obstructive/co [Complications]
KW  - Pulmonary Disease, Chronic Obstructive/pp [Physiopathology]
KW  - Risk Assessment
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - MedStar Washington Hospital Center
KW  - Medicine/Pulmonary-Critical Care
N2  - CONCLUSION: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry; 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; 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); 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
UR  - http://dx.doi.org/10.2147/COPD.S66798
ER  -