A simplified score to quantify comorbidity in COPD.
<h4>Importance</h4>Comorbidities are common in COPD, but quantifying their burden is difficult. Currently there is a COPD-specific comorbidity index to predict mortality and another to predict general quality of life. We sought to develop and validate a COPD-specific comorbidity score th...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0114438 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849332519615332352 |
|---|---|
| author | Nirupama Putcha Milo A Puhan M Bradley Drummond MeiLan K Han Elizabeth A Regan Nicola A Hanania Carlos H Martinez Marilyn Foreman Surya P Bhatt Barry Make Joe Ramsdell Dawn L DeMeo R Graham Barr Stephen I Rennard Fernando Martinez Edwin K Silverman James Crapo Robert A Wise Nadia N Hansel |
| author_facet | Nirupama Putcha Milo A Puhan M Bradley Drummond MeiLan K Han Elizabeth A Regan Nicola A Hanania Carlos H Martinez Marilyn Foreman Surya P Bhatt Barry Make Joe Ramsdell Dawn L DeMeo R Graham Barr Stephen I Rennard Fernando Martinez Edwin K Silverman James Crapo Robert A Wise Nadia N Hansel |
| author_sort | Nirupama Putcha |
| collection | DOAJ |
| description | <h4>Importance</h4>Comorbidities are common in COPD, but quantifying their burden is difficult. Currently there is a COPD-specific comorbidity index to predict mortality and another to predict general quality of life. We sought to develop and validate a COPD-specific comorbidity score that reflects comorbidity burden on patient-centered outcomes.<h4>Materials and methods</h4>Using the COPDGene study (GOLD II-IV COPD), we developed comorbidity scores to describe patient-centered outcomes employing three techniques: 1) simple count, 2) weighted score, and 3) weighted score based upon statistical selection procedure. We tested associations, area under the Curve (AUC) and calibration statistics to validate scores internally with outcomes of respiratory disease-specific quality of life (St. George's Respiratory Questionnaire, SGRQ), six minute walk distance (6MWD), modified Medical Research Council (mMRC) dyspnea score and exacerbation risk, ultimately choosing one score for external validation in SPIROMICS.<h4>Results</h4>Associations between comorbidities and all outcomes were comparable across the three scores. All scores added predictive ability to models including age, gender, race, current smoking status, pack-years smoked and FEV1 (p<0.001 for all comparisons). Area under the curve (AUC) was similar between all three scores across outcomes: SGRQ (range 0·7624-0·7676), MMRC (0·7590-0·7644), 6MWD (0·7531-0·7560) and exacerbation risk (0·6831-0·6919). Because of similar performance, the comorbidity count was used for external validation. In the SPIROMICS cohort, the comorbidity count performed well to predict SGRQ (AUC 0·7891), MMRC (AUC 0·7611), 6MWD (AUC 0·7086), and exacerbation risk (AUC 0·7341).<h4>Conclusions</h4>Quantifying comorbidity provides a more thorough understanding of the risk for patient-centered outcomes in COPD. A comorbidity count performs well to quantify comorbidity in a diverse population with COPD. |
| format | Article |
| id | doaj-art-4a3d969c0f6843ceb3306fae54f714aa |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-4a3d969c0f6843ceb3306fae54f714aa2025-08-20T03:46:11ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11443810.1371/journal.pone.0114438A simplified score to quantify comorbidity in COPD.Nirupama PutchaMilo A PuhanM Bradley DrummondMeiLan K HanElizabeth A ReganNicola A HananiaCarlos H MartinezMarilyn ForemanSurya P BhattBarry MakeJoe RamsdellDawn L DeMeoR Graham BarrStephen I RennardFernando MartinezEdwin K SilvermanJames CrapoRobert A WiseNadia N Hansel<h4>Importance</h4>Comorbidities are common in COPD, but quantifying their burden is difficult. Currently there is a COPD-specific comorbidity index to predict mortality and another to predict general quality of life. We sought to develop and validate a COPD-specific comorbidity score that reflects comorbidity burden on patient-centered outcomes.<h4>Materials and methods</h4>Using the COPDGene study (GOLD II-IV COPD), we developed comorbidity scores to describe patient-centered outcomes employing three techniques: 1) simple count, 2) weighted score, and 3) weighted score based upon statistical selection procedure. We tested associations, area under the Curve (AUC) and calibration statistics to validate scores internally with outcomes of respiratory disease-specific quality of life (St. George's Respiratory Questionnaire, SGRQ), six minute walk distance (6MWD), modified Medical Research Council (mMRC) dyspnea score and exacerbation risk, ultimately choosing one score for external validation in SPIROMICS.<h4>Results</h4>Associations between comorbidities and all outcomes were comparable across the three scores. All scores added predictive ability to models including age, gender, race, current smoking status, pack-years smoked and FEV1 (p<0.001 for all comparisons). Area under the curve (AUC) was similar between all three scores across outcomes: SGRQ (range 0·7624-0·7676), MMRC (0·7590-0·7644), 6MWD (0·7531-0·7560) and exacerbation risk (0·6831-0·6919). Because of similar performance, the comorbidity count was used for external validation. In the SPIROMICS cohort, the comorbidity count performed well to predict SGRQ (AUC 0·7891), MMRC (AUC 0·7611), 6MWD (AUC 0·7086), and exacerbation risk (AUC 0·7341).<h4>Conclusions</h4>Quantifying comorbidity provides a more thorough understanding of the risk for patient-centered outcomes in COPD. A comorbidity count performs well to quantify comorbidity in a diverse population with COPD.https://doi.org/10.1371/journal.pone.0114438 |
| spellingShingle | Nirupama Putcha Milo A Puhan M Bradley Drummond MeiLan K Han Elizabeth A Regan Nicola A Hanania Carlos H Martinez Marilyn Foreman Surya P Bhatt Barry Make Joe Ramsdell Dawn L DeMeo R Graham Barr Stephen I Rennard Fernando Martinez Edwin K Silverman James Crapo Robert A Wise Nadia N Hansel A simplified score to quantify comorbidity in COPD. PLoS ONE |
| title | A simplified score to quantify comorbidity in COPD. |
| title_full | A simplified score to quantify comorbidity in COPD. |
| title_fullStr | A simplified score to quantify comorbidity in COPD. |
| title_full_unstemmed | A simplified score to quantify comorbidity in COPD. |
| title_short | A simplified score to quantify comorbidity in COPD. |
| title_sort | simplified score to quantify comorbidity in copd |
| url | https://doi.org/10.1371/journal.pone.0114438 |
| work_keys_str_mv | AT nirupamaputcha asimplifiedscoretoquantifycomorbidityincopd AT miloapuhan asimplifiedscoretoquantifycomorbidityincopd AT mbradleydrummond asimplifiedscoretoquantifycomorbidityincopd AT meilankhan asimplifiedscoretoquantifycomorbidityincopd AT elizabetharegan asimplifiedscoretoquantifycomorbidityincopd AT nicolaahanania asimplifiedscoretoquantifycomorbidityincopd AT carloshmartinez asimplifiedscoretoquantifycomorbidityincopd AT marilynforeman asimplifiedscoretoquantifycomorbidityincopd AT suryapbhatt asimplifiedscoretoquantifycomorbidityincopd AT barrymake asimplifiedscoretoquantifycomorbidityincopd AT joeramsdell asimplifiedscoretoquantifycomorbidityincopd AT dawnldemeo asimplifiedscoretoquantifycomorbidityincopd AT rgrahambarr asimplifiedscoretoquantifycomorbidityincopd AT stephenirennard asimplifiedscoretoquantifycomorbidityincopd AT fernandomartinez asimplifiedscoretoquantifycomorbidityincopd AT edwinksilverman asimplifiedscoretoquantifycomorbidityincopd AT jamescrapo asimplifiedscoretoquantifycomorbidityincopd AT robertawise asimplifiedscoretoquantifycomorbidityincopd AT nadianhansel asimplifiedscoretoquantifycomorbidityincopd AT nirupamaputcha simplifiedscoretoquantifycomorbidityincopd AT miloapuhan simplifiedscoretoquantifycomorbidityincopd AT mbradleydrummond simplifiedscoretoquantifycomorbidityincopd AT meilankhan simplifiedscoretoquantifycomorbidityincopd AT elizabetharegan simplifiedscoretoquantifycomorbidityincopd AT nicolaahanania simplifiedscoretoquantifycomorbidityincopd AT carloshmartinez simplifiedscoretoquantifycomorbidityincopd AT marilynforeman simplifiedscoretoquantifycomorbidityincopd AT suryapbhatt simplifiedscoretoquantifycomorbidityincopd AT barrymake simplifiedscoretoquantifycomorbidityincopd AT joeramsdell simplifiedscoretoquantifycomorbidityincopd AT dawnldemeo simplifiedscoretoquantifycomorbidityincopd AT rgrahambarr simplifiedscoretoquantifycomorbidityincopd AT stephenirennard simplifiedscoretoquantifycomorbidityincopd AT fernandomartinez simplifiedscoretoquantifycomorbidityincopd AT edwinksilverman simplifiedscoretoquantifycomorbidityincopd AT jamescrapo simplifiedscoretoquantifycomorbidityincopd AT robertawise simplifiedscoretoquantifycomorbidityincopd AT nadianhansel simplifiedscoretoquantifycomorbidityincopd |