Concise guidance for <scp>COPD</scp>

Dabscheck, Eli; McDonald, Christine F; Yang, Ian A.

doi:10.1111/resp.13934

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Although there is continued debate regarding which reference norms to use in specific populations, [45][46][47] in the Australian context it is recommended to use GLI-2012 'others/mixed' reference norms for the adult Indigenous population. 23 This study has demonstrated the potential effects of using these recommendations [23][24][25][26] for the classification of [48][49][50][51] In this study, we observed that the agreement between clinical diagnosis of COPD as per medical records entry Open access against spirometry criteria was only about 54%. It is not clear, given the fact that Indigenous patients have a higher prevalence of smoking and respiratory conditions, 7 8 if health practitioners may have a preconceived perception that any or all Indigenous patients presenting with respiratory symptoms will have COPD.…”

Section: Discussionmentioning

confidence: 94%

“…Spirometry parameters are crucial in day-to-day clinical practice, not only for the accurate diagnosis and classifying the severity of AFL, but also in the management of COPD with airway directed inhaled pharmacotherapy. [25][26][27] While it is possible the high prevalence of 'severe' AFL categorisation among Indigenous Australian patients with COPD accurately represents the severity of the underlying disease as noted in this study, it is also plausible that these high rates of 'severe' categorisation are an artefact of the use of reference values drawn from non-Indigenous populations. 28 The Australian COPD-X tool provides stepwise recommendations for the use of airway directed inhaled pharmacotherapy, such as short-acting BD, short-acting muscarinic antagonists, long-acting β-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids (ICS) as per the severity assessed on spirometry criteria.…”

Section: Discussionmentioning

confidence: 99%

“…25 26 The COPD-X guidelines have also been endorsed by the Royal Australian College of General Practitioners for use at the primary healthcare level. [25][26][27] Nevertheless, the implications of utilising these recommended spirometry parameters in assessing/classifying the severity of AFL among Indigenous Australians have not been investigated. Moreover, the spirometry cut-off values to assess the severity of AFL differ between the two recommendations (ie, 'GOLD' vs 'COPD-X').…”

Section: Introductionmentioning

confidence: 99%

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Implications of using the GLI-2012, GOLD and Australian COPD-X recommendations in assessing the severity of airflow limitation on spirometry among an Indigenous population with COPD: an Indigenous Australians perspective study

et al. 2021

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BackgroundAssessment of airflow limitation (AFL) is crucial in the clinical evaluation of patients with chronic obstructive pulmonary disease (COPD). However, in the absence of normative reference values among adult Australian Indigenous population, the implications of utilising the Global Lung Function Initiative (GLI-2012), Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the Australian concise COPD-X recommended severity classifications is not known. Moreover, spirometry values (forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)) are observed to be 20%–30% lower in an apparently healthy Indigenous population in comparison to Caucasian counterparts.MethodsAdult Indigenous patients diagnosed to have COPD on spirometry (postbronchodilator (BD) FEV1/FVC <0.7 ((GOLD, (COPD-X)) and ≤lower limit of normal (others/mixed reference equations) for GLI-2012) were assessed for AFL severity classifications on Post-BD FEV1 values (mild, moderate, severe, very severe) as per the recommended classifications.ResultsFrom a total of 742 unique patient records of Indigenous Australians, 253 were identified to have COPD via GOLD/COPD-X criteria (n=238) or GLI-2012 criteria (n=238) with significant agreeance between criteria (96%, κ=0.901). Of these, the majority were classified as having moderate or severe/very-severe AFL with significant variability across classification criteria (COPD-X (40%–43%), GOLD (33%–65%), GLI-2012 (18%–75%)). The FVC and FEV1 values also varied significantly between classification criterion (COPD-X/GOLD/GLI-2012) within the same AFL category, with COPD-X ‘moderate’ AFL almost matching ‘severe’ AFL categorisation by GOLD or GLI-2012.ConclusionsHealth professionals caring for Indigenous patients with COPD should be aware of the clinical implications and consequences of utilising various recommended AFL classifications in the absence of validated spirometry reference norms among adult Indigenous patients.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implications of using the GLI-2012, GOLD and Australian COPD-X recommendations in assessing the severity of airflow limitation on spirometry among an Indigenous population with COPD: an Indigenous Australians perspective study

et al. 2021

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“…Research into the underlying mechanisms of COPD and updated clinical and treatment guidance for clinicians have been published. Restructured COPD guidelines were delivered including a concise review of COPD‐X published in Respirology 27 …”

Section: New Developments In Copdmentioning

confidence: 99%

Contemporary Concise Review 2020: Chronic obstructive pulmonary disease

MacDonald

Bardin

2021

Respirology

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“…Epidemiological studies showed that COPD has already become the 3rd most common cause of mortality worldwide [5][6][7]. It is expected that the global burden of COPD may continue to increase in the coming decades due to the aggravation of air pollution and the aging population [8][9][10]. Moreover, COPD is associated with decreased exercise endurance that may adversely affect patients' quality of life [11,12].…”

Section: Introductionmentioning

confidence: 99%

Effect of Endurance Training in COPD Patients Undergoing Pulmonary Rehabilitation: A Meta-Analysis

Wang

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. The efficacy of endurance training (ET) on patients with chronic obstructive pulmonary disease (COPD) has been controversial. This study was aimed at meta-analyzing the effect of ET in COPD patients undergoing pulmonary rehabilitation. Methods. The literature retrieval was performed in databases to screen relevant literature. Inclusion criteria were as follows: (1) subjects—COPD patients; (2) inclusion of interventional and control groups; (3) intervention measures—the interventional group received whole-body ET and other lung rehabilitation training, while the control group did not receive intervention or other lung rehabilitation training; (4) outcome indicators which included at least one of the following—6MWD, modified Medical Research Council questionnaire (mMRC), and COPD Assessment Test (CAT); and (5) study type—randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the risk of bias. The chi-square test was used to evaluate the magnitude of heterogeneity. Subgroup analysis was used to explore the source of heterogeneity. A funnel plot and Egger’s test were used to evaluate publication bias. Results. The 6MWD in the ET group was significantly higher than that in the control group ( MD = 47.20 , 95% CI [28.60, 65.79], P < 0.00001 ). Significant heterogeneity ( P < 0.00001 , I 2 = 76 % ) without publication bias ( P > 0.05 ) was noted. Subgroup analysis showed that the 6MWD of the ET group was significantly larger than that of the control group without heterogeneity ( P = 0.63 , I 2 = 0 % ; P = 0.59 , I 2 = 0 % ) in both the no training subgroup ( MD = 79.26 , 95% CI [72.69, 85.82], P < 0.00001 ) and other rehabilitation training group ( MD = 23.64 , 95% CI [6.70, 40.57], P = 0.006 ). The mMRC score ( MD = − 0.72 , 95% CI [-1.09, -0.34], P = 0.002 ) and CAT ( MD = − 6.07 , 95% CI [-7.28, -4.87], P < 0.00001 ) of the ET group were significantly lower than those of the control group. There was no heterogeneity ( P = 0.32 , I 2 = 15 % ; P = 0.16 , I 2 = 41 % ). Conclusion. ET can improve patients’ motor function and reduce dyspnea. ET might be incorporated as an important part of lung rehabilitation training.

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Concise guidance for COPD

Cited by 5 publications

References 4 publications

Implications of using the GLI-2012, GOLD and Australian COPD-X recommendations in assessing the severity of airflow limitation on spirometry among an Indigenous population with COPD: an Indigenous Australians perspective study

Implications of using the GLI-2012, GOLD and Australian COPD-X recommendations in assessing the severity of airflow limitation on spirometry among an Indigenous population with COPD: an Indigenous Australians perspective study

Contemporary Concise Review 2020: Chronic obstructive pulmonary disease

Effect of Endurance Training in COPD Patients Undergoing Pulmonary Rehabilitation: A Meta-Analysis

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