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Respiratory Research
Published in: Respiratory Research 1/2011

Open Access 01-12-2011 | Review

Multidimensional prognostic indices for use in COPD patient care. A systematic review

Authors: Wouter D van Dijk, Lisette van den Bemt, Saskia van den Haak-Rongen, Erik Bischoff, Chris van Weel, Johannes CCM in 't Veen, Tjard RJ Schermer

Published in: Respiratory Research | Issue 1/2011

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Abstract

Background

A growing number of prognostic indices for chronic obstructive pulmonary disease (COPD) is developed for clinical use. Our aim is to identify, summarize and compare all published prognostic COPD indices, and to discuss their performance, usefulness and implementation in daily practice.

Methods

We performed a systematic literature search in both Pubmed and Embase up to September 2010. Selection criteria included primary publications of indices developed for stable COPD patients, that predict future outcome by a multidimensional scoring system, developed for and validated with COPD patients only. Two reviewers independently assessed the index quality using a structured screening form for systematically scoring prognostic studies.

Results

Of 7,028 articles screened, 13 studies comprising 15 indices were included. Only 1 index had been explored for its application in daily practice. We observed 21 different predictors and 7 prognostic outcomes, the latter reflecting mortality, hospitalization and exacerbation. Consistent strong predictors were FEV1 percentage predicted, age and dyspnoea. The quality of the studies underlying the indices varied between fairly poor and good. Statistical methods to assess the predictive abilities of the indices were heterogenic. They generally revealed moderate to good discrimination, when measured. Limitations: We focused on prognostic indices for stable disease only and, inevitably, quality judgment was prone to subjectivity.

Conclusions

We identified 15 prognostic COPD indices. Although the prognostic performance of some of the indices has been validated, they all lack sufficient evidence for implementation. Whether or not the use of prognostic indices improves COPD disease management or patients' health is currently unknown; impact studies are required to establish this.
Appendix
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Metadata
Title
Multidimensional prognostic indices for use in COPD patient care. A systematic review
Authors
Wouter D van Dijk
Lisette van den Bemt
Saskia van den Haak-Rongen
Erik Bischoff
Chris van Weel
Johannes CCM in 't Veen
Tjard RJ Schermer
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2011
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-12-151

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