Functional status measurement in COPD: a review of available methods and their feasibility in primary care

Kocks, Janwillem; Asijee, Guus M.; Tsiligianni, Ioanna; Kerstjens, Huib A. M.; Molen, Thys van der

doi:10.4104/pcrj.2011.00031

Cited by 92 publications

(96 citation statements)

References 49 publications

(27 reference statements)

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“…There may be one or more reasons for a patient to seek healthcare, including COPD symptoms, respiratory tract infection, smoking-related symptoms, general health, co-morbidities, or disease-related complications (weight loss, right heart failure, depression, deconditioning). As a next step, demographic, historical and clinical characteristics, and objective measures like lung function and physical activity 11 should be established (Figure 3). Disease impact on an individual's daily life and well-being, as well as co-morbidities, complications, and medication use, should be evaluated.…”

Section: Best Current Controlmentioning

confidence: 99%

A new perspective on optimal care for patients with COPD

Postma

Anzueto²,

Calverley

et al. 2011

Primary Care Respiratory Journal

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Worldwide, clinicians face the task of providing millions of patients with the best possible treatment and management of COPD. Currently, management primarily involves short-term 'here-and-now' goals, targeting immediate patient benefit. However, although there is considerable knowledge available to assist clinicians in minimising the current impact of COPD on patients, relatively little is known about which dominant factors predict future risks. These predictors may vary for different outcomes, such as exacerbations, mortality, co-morbidities, and the long-term consequences of COPD. We propose a new paradigm to achieve 'optimal COPD care' based on the concept that here-and-now goals should be integrated with goals to improve long-term outcomes and reduce future risks. Whilst knowledge on risk factors for poorer outcomes in COPD is growing and some data exist on positive effects of pharmacological interventions, information on defining the benefits of all commonly used interventions for reducing the risk of various future disease outcomes is still scarce. Greater insight is needed into the relationships between the two pillars of optimal COPD care: 'best current control' and 'future risk reduction'. This broader approach to disease management should result in improved care for every COPD patient now and into the future.

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Section: Best Current Controlmentioning

confidence: 99%

A new perspective on optimal care for patients with COPD

Postma

Anzueto²,

Calverley

et al. 2011

Primary Care Respiratory Journal

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“…12,13 In daily clinical practice a standard 6MWT can be difficult to execute in non-specialist settings, such as in a general practitioner's office or a healthcare service with low 6MWT expertise. 14- 16 We evaluated a new scoring system for the risk of oxygen desaturation during walking in COPD patients, in a pure COPD population, using the combination of variables in the 6MWT.…”

Section: Introductionmentioning

confidence: 99%

Predicting Walking-Induced Oxygen Desaturations in COPD Patients: A Statistical Model

et al. 2013

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BACKGROUND: Oxygen desaturation during walking can have important consequence on prognosis of COPD patients. However, a standard 6-min walk test (6MWT), useful in detecting desaturation in COPD patients, can be difficult to execute in some settings of COPD management, as in the community healthcare service. We evaluated a new scoring system for the risk of oxygen desaturation during walking in COPD patients: the walking desaturation score. METHODS: We collected data from symptomatic COPD in-patients admitted for rehabilitation (derivation cohort) and out-patients referred to the local community health service (validation cohort). S pO 2 was monitored during 6MWT, and the subjects were classified as walking desaturators or non-desaturators. By a regression analysis model we assigned a weighted score proportional to the measured percentage of explained variance for each variable. Risk estimates were computed as odds ratios. A receiver operating characteristic curve analysis and a Hosmer-Lemeshow goodness-of-fit test were then performed to measure discrimination and calibration of walking desaturation score. RESULTS: Baseline characteristics in the derivation cohort (n ‫؍‬ 435, 74% of whom were walking desaturators) and the validation cohort (n ‫؍‬ 238, 37% of whom were walking desaturators) were different. Resting arterial oxygen saturation measured from an arterial blood sample, P aO 2 , and percent-of-predicted FEV 1 were the variables that predicted walking desaturation. The proportion of walking desaturators (and odds ratio estimate) gradually increased according to walking desaturation score (range 0 -6) and associated categories of desaturation risk (total walking desaturation score: low 0 or 1, high 2-3, very high 4 -6) (chi-square P < .001). There was considerable predictive discrimination (area under the curve 0.90, 95% CI 0.86 -0.93, P < .001), and calibration (Hosmer-Lemeshow chi-square 1.31, P ‫؍‬ .86) values have been shown. CONCLUSIONS: Walking desaturation score accurately predicts and classifies the risk of walking desaturation in COPD patients. ClinicalTrials.gov Number NCT01303913.

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“…Developing a research question that aims to explore "function" as an outcome necessitates an examination of available methods developed to reliably measure the construct [38]. Moreover, appraisal of psychometric evidence to support the reliability and validity of such measures is required.…”

Section: Conclusion and Implications For Nursing Researchmentioning

confidence: 99%

“…Keeping Leidy's framework in the forefront during study design decisions, researchers must ask themselves if the aim of the intervention is to improve "capacity" or "performance" in the context of the NYHA or DTS. However, researchers are not limited ot the NYHA and DTS, several tools are available to consider [38].…”

Section: Conclusion and Implications For Nursing Researchmentioning

confidence: 99%

A Comparison of the NYHA Classification and the Duke Treadmill Score in Patients with Cardiovascular Disease

Carroll¹,

Harkness²,

McGillion³

2014

OJN

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Aim: A discussion of the measurement of functional status in cardiovascular research. Background: Selection of appropriate outcome measures and instrumentation is vital for nurse researchers to ensure that outcomes align conceptually and are measured using reliable and valid tools. Functional status is a well-known outcome in cardiovascular research-however attention to underlying conceptual differences that may influence choices of whether to include subjective or objective measures is needed. Design: This work is a discussion paper: seminal research reporting the development, validation, and reliability testing of the NYHA classification system and the Duke Treadmill Score. Implications for nursing: Conceptually clarity and comprehensive appraisal of the reliability and validity of outcome measures in nursing research are essential to ensure high level of quality outcomes that will benefit patients.

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Functional status measurement in COPD: a review of available methods and their feasibility in primary care

Cited by 92 publications

References 49 publications

A new perspective on optimal care for patients with COPD

A new perspective on optimal care for patients with COPD

Predicting Walking-Induced Oxygen Desaturations in COPD Patients: A Statistical Model

A Comparison of the NYHA Classification and the Duke Treadmill Score in Patients with Cardiovascular Disease

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