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Respiratory Research
Published in: Respiratory Research 1/2022

Open Access 01-12-2022 | Chronic Obstructive Lung Disease | Research

COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time

Authors: Alda Marques, Sara Souto-Miranda, Ana Machado, Ana Oliveira, Cristina Jácome, Joana Cruz, Vera Enes, Vera Afreixo, Vitória Martins, Lília Andrade, Carla Valente, Diva Ferreira, Paula Simão, Dina Brooks, Ana Helena Tavares

Published in: Respiratory Research | Issue 1/2022

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Abstract

Background and objective

Profiles of people with chronic obstructive pulmonary disease (COPD) often do not describe treatable traits, lack validation and/or their stability over time is unknown. We aimed to identify COPD profiles and their treatable traits based on simple and meaningful measures; to develop and validate a decision tree and to explore profile stability over time.

Methods

An observational, prospective study was conducted. Clinical characteristics, lung function, symptoms, impact of the disease (COPD Assessment Test—CAT), health-related quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. A decision tree was developed and validated cross-sectionally. Stability was explored over time with the ratio between the number of timepoints that a participant was classified in the same profile and the total number of timepoints (i.e., 6).

Results

352 people with COPD (67.4 ± 9.9 years; 78.1% male; FEV1 = 56.2 ± 20.6% predicted) participated and 90 (67.6 ± 8.9 years; 85.6% male; FEV1 = 52.1 ± 19.9% predicted) were followed-up. Four profiles were identified with distinct treatable traits. The decision tree included CAT (< 18 or ≥ 18 points); age (< 65 or ≥ 65 years) and FEV1 (< 48 or ≥ 48% predicted) and had an agreement of 71.7% (Cohen’s Kappa = 0.62, p < 0.001) with the actual profiles. 48.9% of participants remained in the same profile whilst 51.1% moved between two (47.8%) or three (3.3%) profiles over time. Overall stability was 86.8 ± 15%.

Conclusion

Four profiles and treatable traits were identified with simple and meaningful measures possibly available in low-resource settings. A decision tree with three commonly used variables in the routine assessment of people with COPD is now available for quick allocation to the identified profiles in clinical practice. Profiles and treatable traits may change over time in people with COPD hence, regular assessments to deliver goal-targeted personalised treatments are needed.
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Metadata
Title
COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time
Authors
Alda Marques
Sara Souto-Miranda
Ana Machado
Ana Oliveira
Cristina Jácome
Joana Cruz
Vera Enes
Vera Afreixo
Vitória Martins
Lília Andrade
Carla Valente
Diva Ferreira
Paula Simão
Dina Brooks
Ana Helena Tavares
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2022
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-022-01954-6

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