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Adjusting for COPD severity in database research: developing and validating an algorithm
| Content Provider | Semantic Scholar |
|---|---|
| Author | Goossens, Lucas M. A. Baker, Christine L. Monz, Brigitta U. Zou, Kelly H. Mölken, Maureen Pmh Rutten-van |
| Copyright Year | 2011 |
| Abstract | PURPOSE When comparing chronic obstructive lung disease (COPD) interventions in database research, it is important to adjust for severity. Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines grade severity according to lung function. Most databases lack data on lung function. Previous database research has approximated COPD severity using demographics and healthcare utilization. This study aims to derive an algorithm for COPD severity using baseline data from a large respiratory trial (UPLIFT). METHODS Partial proportional odds logit models were developed for probabilities of being in GOLD stages II, III and IV. Concordance between predicted and observed stage was assessed using kappa-statistics. Models were estimated in a random selection of 2/3 of patients and validated in the remainder. The analysis was repeated in a subsample with a balanced distribution across severity stages. Univariate associations of COPD severity with the covariates were tested as well. RESULTS More severe COPD was associated with being male and younger, having quit smoking, lower BMI, osteoporosis, hospitalizations, using certain medications, and oxygen. After adjusting for these variables, co-morbidities, previous healthcare resource use (eg, emergency room, hospitalizations) and inhaled corticosteroids, xanthines, or mucolytics were no longer independently associated with COPD severity, although they were in univariate tests. The concordance was poor (kappa = 0.151) and only slightly better in the balanced sample (kappa = 0.215). CONCLUSION COPD severity cannot be reliably predicted from demographics and healthcare use. This limitation should be considered when interpreting findings from database studies, and additional research should explore other methods to account for COPD severity. |
| Starting Page | 669 |
| Ending Page | 678 |
| Page Count | 10 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 22259243 |
| DOI | 10.2147/copd.s26214 |
| Journal | International journal of chronic obstructive pulmonary disease |
| Volume Number | 6 |
| Alternate Webpage(s) | https://www.dovepress.com/getfile.php?fileID=11534 |
| Alternate Webpage(s) | https://repub.eur.nl/pub/75023/REPUB_75023-OA.pdf |
| Alternate Webpage(s) | https://doi.org/10.2147/COPD.S26214 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Accident and Emergency department Adrenal Cortex Hormones Chronic Obstructive Airway Disease Databases Demography Hospitalization Lung Diseases, Obstructive Lung diseases Mental association Morbidity - disease rate Osteoporosis Oxygen Patients Respiratory physiology Xanthines algorithm |
| Content Type | Text |
| Resource Type | Article |
