Derivation and validation of a composite index of severity in chronic obstructive pulmonary disease: the DOSE Index.

Abstract:

RATIONALE:Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a multicomponent disease with systemic consequences and effects on quality of life. Single measures such as lung function provide a limited reflection of how the disease affects patients. Composite measures have the potential to account for many of the facets of COPD. OBJECTIVES:To derive and validate a multicomponent assessment tool of COPD severity that is applicable to all patients and health care settings. METHODS:The index was derived using data from 375 patients with COPD in primary care. Regression analysis led to a model explaining 48% of the variance in health status as measured by the Clinical COPD Questionnaire with four components: dyspnea (D), airflow obstruction (O), smoking status (S), and exacerbation frequency (E). The DOSE Index was validated in cross-sectional and longitudinal samples in various health care settings in Holland, Japan, and the United Kingdom. MEASUREMENTS AND MAIN RESULTS:The DOSE Index correlated with health status in all data sets. A high DOSE Index score (> or = 4) was associated with a greater risk of hospital admission (odds ratio, 8.3 [4.1-17]) or respiratory failure (odds ratio, 7.8 [3.4-18.3]). The index predicted exacerbations in the subsequent year (P < or = 0.014). CONCLUSIONS:The DOSE Index is a simple, valid tool for assessing the severity of COPD. The index is related to a range of clinically important outcomes such as health care consumption and predicts future events.

authors

Jones RC,Donaldson GC,Chavannes NH,Kida K,Dickson-Spillmann M,Harding S,Wedzicha JA,Price D,Hyland ME

doi

10.1164/rccm.200902-0271OC

subject

Has Abstract

pub_date

2009-12-15 00:00:00

pages

1189-95

issue

12

eissn

1073-449X

issn

1535-4970

pii

200902-0271OC

journal_volume

180

pub_type

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