A predictive model of hospitalisation and death from chronic obstructive pulmonary disease

Schembri, Stuart; Anderson, William J.; Morant, S. V.; Winter, Janet; Thompson, P. E.; Pettitt, Daniel; MacDonald, Thomas M.; Winter, John

doi:10.1016/j.rmed.2009.04.021

Cited by 53 publications

(52 citation statements)

References 16 publications

(7 reference statements)

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“…All models included a strong association between age and mortality, which was in line with studies found in the literature [32,33,[35][36][37][38]. Validation against trial results also showed a difference in 12 mortality between young and old patients for the trial as well as most models.…”

Section: Discussionsupporting

confidence: 85%

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Patient Heterogeneity in Health Economic Decision Models for Chronic Obstructive Pulmonary Disease: Are Current Models Suitable to Evaluate Personalized Medicine?

et al. 2016

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Patient heterogeneity in health economic decision models for chronic obstructive pulmonary disease (COPD): are current models suitable to evaluate personalized medicine? 3 AbstractObjectives: To assess how suitable current COPD cost-effectiveness models are to evaluate personalized treatment options for COPD by exploring the type of heterogeneity included in current models and by validating outcomes for subgroups of patients.Methods: A consortium of COPD modelling groups completed three tasks. First, they reported all patient characteristics included in the model and provided the level of detail in which the input parameters were specified. Second, groups simulated disease progression, mortality, quality-adjusted life-years (QALYs) and costs for hypothetical subgroups of patients that differed in terms of gender, age, smoking status and lung function (FEV1% predicted). Finally, model outcomes for exacerbations and mortality for subgroups of patients were validated against published subgroup results of two large COPD trials.Results: Nine COPD modelling groups participated. Most models included gender (seven), age (nine), smoking status (six) and FEV1% predicted (nine), mainly to specify disease progression and mortality.Trial results showed higher exacerbation rates for females (found in one model), higher mortality rates for males (two models), lower mortality for younger patients (four models), and higher exacerbation and mortality rates in patients with severe COPD (four models).Conclusions: The majority of currently available COPD cost-effectiveness models are able to evaluate the cost-effectiveness of personalized treatment based on gender, age, smoking and FEV1% predicted. Treatment in COPD is however, more likely to be personalized based on clinical parameters. Two models include several clinical patient characteristics and are therefore most suitable to evaluate personalized treatment, although some important clinical parameters are still missing.4

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Section: Discussionsupporting

confidence: 85%

“…The difference in mortality is less clear from the literature. Some studies reported lower mortality rates for females [32][33][34], while others found no difference [35][36][37][38]. Only two models specified quality of life by gender, while several studies found a lower quality of life for female patients [39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Patient Heterogeneity in Health Economic Decision Models for Chronic Obstructive Pulmonary Disease: Are Current Models Suitable to Evaluate Personalized Medicine?

et al. 2016

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“…We also calculated modifications of the BODE index, including the mBODE (which replaces 6MWD with oxygen uptake) [20], e-BODE (BODE plus exacerbations) [21], and BODEx (substitution of exacerbations for exercise capacity) [21]. We also calculated the ADO index (age, dyspnoea and FEV1) [22], the COPD Prognostic Index (CPI) (quality of life standardised by the Chronic Respiratory Questionnaire (CRQ) or St George's Respiratory Questionnaire (SGRQ), FEV1, age, sex, BMI, exacerbation history and cardiovascular disease history) [23], the SAFE index (quality of life by SGRQ, FEV1 and 6MWD) [24], the HADO index (health status, activity, dyspnoea and FEV1) [25], the COPDSS-COPD severity score (respiratory symptoms, systemic corticosteroid use, other COPD medication use, previous hospitalisation or intubation for respiratory disease and home oxygen use) [26,27], TARDIS (age, BMI, dyspnoea, airflow obstruction, hospitalisations and influenza vaccination) [28], and the DOSE index (dyspnoea, smoking status, FEV1 and prior exacerbation history) [29]. Comorbidities were quantified by means of the Charlson index, excluding COPD [30].…”

Section: Indices Calculationsmentioning

confidence: 99%

Multicomponent indices to predict survival in COPD: the COCOMICS study

Marı́n

Alfageme²,

Almagro

et al. 2012

Eur Respir J

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Guidelines recommend defining chronic obstructive pulmonary disease (COPD) by airflow obstruction and other factors, but no studies have evaluated the ability of existing multicomponent indices to predict mortality up to 10 years.We conducted a patient-based pooled analysis. Survival analysis and C statistics were used to determine the best COPD index/indices according to several construct variables and by varying time-points. Individual data of 3633 patients from 11 COPD cohorts were collected, totalling the experience of 15 878 person-years.Overall, there were 1245 death events within our cohorts, with a Kaplan-Meier survival of 0.963 at 6 months, which was reduced to 0.432 at 10 years. In all patients, ADO (age, dyspnoea and forced expiratory volume in 1 s), BODE (body mass index, airflow obstruction, dyspnoea and exercise capacity) and e-BODE (BODE plus exacerbations) were the best indices to predict 6-month mortality. The ADO index was the best to predict 12-month (C statistic 0.702), 5-year (C statistic 0.695) and 10-year mortality (C statistic 0.698), and was significantly better than BODE (all p,0.05). The best indices to predict death by C statistics when adjusting by age were e-BODE, BODEx (substitution of exacerbations for exercise capacity) and BODE.No index predicts short-term survival of COPD well. All BODE modifications scored better than ADO after age adjustment. The ADO and BODE indices are overall the most valid multicomponent indices to predict time to death in all COPD patients. @ERSpublicationsNo index predicts short-term survival of COPD well: all BODE modifications score better than ADO after age adjustment

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“…The strength of our disease-specific database lies within all patients having a diagnosis of COPD made by a primary or secondary care physician, thereby providing us with an unselected community population of COPD patients for analysis [14]. We acknowledge that our study has limitations given that it was retrospective and observational in design.…”

Section: Discussionmentioning

confidence: 99%

“…TARDIS is a COPD disease-specific database that has previously been used as the basis for previous published COPD research, thereby providing us with an unselected community population of COPD patients for analysis [14,15].…”

Section: Methodsmentioning

confidence: 99%

Impact of Left Ventricular Hypertrophy on Survival in Chronic Obstructive Pulmonary Disease

Short

Anderson

Elder

et al. 2015

Lung

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A predictive model of hospitalisation and death from chronic obstructive pulmonary disease

Abstract: We have developed a model that estimates the risk of respiratory hospitalisation and death in patients with COPD.

Cited by 53 publications

References 16 publications

Patient Heterogeneity in Health Economic Decision Models for Chronic Obstructive Pulmonary Disease: Are Current Models Suitable to Evaluate Personalized Medicine?

Patient Heterogeneity in Health Economic Decision Models for Chronic Obstructive Pulmonary Disease: Are Current Models Suitable to Evaluate Personalized Medicine?

Multicomponent indices to predict survival in COPD: the COCOMICS study

Impact of Left Ventricular Hypertrophy on Survival in Chronic Obstructive Pulmonary Disease

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