Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.

Coton, Sonia, Vollmer, William M, Bateman, Eric, Marks, Guy B, Tan, Wan, Mejza, Filip, Juvekar, Sanjay, Janson, Christer, Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871, P A, Mahesh, Buist, A Sonia and Burney, Peter G J (2017) 'Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.'. COPD: Journal of Chronic Obstructive Pulmonary Disease, Vol 14, Issue 5, pp. 469-475.

Text (This is an Accepted Manuscript of an article published by Taylor & Francis in COPD: Journal of Chronic Obstructive Pulmonary Disease on 11/08/17, available online: http://www.tandfonline.com/10.1080/15412555.2017.1339681) COPD_Mortimer_accepted-version_August-2017.docx - Accepted Version Download (2MB)

Abstract

Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity. We constructed an index of obstruction severity based on the FEV1/FVC ratio, with cut-points dividing the Burden of Obstructive Lung Disease (BOLD) study population into four similarly sized strata to those created by the GOLD criteria that uses FEV1. We measured the agreement between classifications and the validity of the FEV1-based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life (QoL), MRC dyspnoea score and the self-reported exacerbation rate. Agreement between classifications was only fair. FEV1-based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with QoL, exertional dyspnoea and respiratory exacerbations. Severity assessed using the FEV1/FVC ratio is only in moderate agreement with the severity assessed using FEV1 but is equally strongly associated with other outcomes. Severity assessed using the FEV1/FVC ratio is likely to be independent of ethnicity.

Item Type:	Article
Subjects:	WF Respiratory System > WF 140 Diseases of the respiratory system (General) WF Respiratory System > WF 20 Research (General) WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1080/15412555.2017.1339681
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	25 Aug 2017 12:42
Last Modified:	12 Sep 2019 13:07
URI:	https://archive.lstmed.ac.uk/id/eprint/7514

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