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Adequate Patient Characterization in COPD: Reasons to Go Beyond GOLD Classification
- Source :
- Open Respiratory Medicine Journal, 3, 1-9, The Open Respiratory Medicine Journal, Open Respiratory Medicine Journal, 3, pp. 1-9
- Publication Year :
- 2009
- Publisher :
- Bentham Science Publishers Ltd., 2009.
-
Abstract
- Contains fulltext : 79857.pdf (Publisher’s version ) (Open Access) The Global Initiative for Chronic Obstructive Lung Disease (GOLD) serves as a guide to treat and manage different severity classes of patients with COPD. It was suggested that the five categories of FEV(1) % predicted (GOLD 0-4), can be applied for selecting different therapeutic approaches. However, validation of these selective properties is very poor. To determine the relevance of the GOLD staging system for estimating the severity of clinical problems, GOLD 2 (n=70) and GOLD 3 (n=65) patients were drawn from a prospective cohort of patients with COPD and evaluated crosssectionally by a newly developed Nijmegen Integral Assessment Framework (NIAF). The NIAF is a detailed assessment of a wide range of aspects of health status (HS). Significant, though small, differences were found in Static Lung Volumes, Exercise Capacity, Subjective Pulmonary Complaints, Subjective Impairment, and Health-Related QoL, besides Airflow of course. Moreover, overlap between scores of these five HS sub-domains was substantial, indicating small clinical relevance for discernment. No significant differences were found in nine other aspects of HS. It is concluded that GOLD stages do not discriminate in any aspect of HS other than airflow obstruction, and therefore do not help the clinician in deciding which treatment modalities are appropriate.
- Subjects :
- Pulmonary and Respiratory Medicine
COPD
Pediatrics
medicine.medical_specialty
business.industry
Psychological determinants of chronic illness [NCEBP 8]
Exercise capacity
medicine.disease
Airflow obstruction
Article
Obstructive lung disease
Pathogenesis and modulation of inflammation [N4i 1]
medicine
Physical therapy
Clinical significance
Prospective cohort study
business
Gold classification
Staging system
Subjects
Details
- ISSN :
- 18743064
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- The Open Respiratory Medicine Journal
- Accession number :
- edsair.doi.dedup.....f3095872ee6aa985aefa9fdab5b22aea