학술논문
Adequate Patient Characterization in COPD: Reasons to Go Beyond GOLD Classification.
Document Type
Academic Journal
Author
Verhage TL; Departments of Pulmonary Diseases and Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.; Heijdra YF; Molema J; Daudey L; Dekhuijzen PN; Vercoulen JH
Source
Publisher: Bentham Open Country of Publication: United Arab Emirates NLM ID: 101480481 Publication Model: Electronic Cited Medium: Internet ISSN: 1874-3064 (Electronic) Linking ISSN: 18743064 NLM ISO Abbreviation: Open Respir Med J Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
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.