Individualized prediction of lung-function decline in chronic obstructive pulmonary disease
| Autor: | Mohsen Sadatsafavi, S. F. Paul Man, John E. Connett, Raymond T. Ng, C. Martin Tammemagi, Don D. Sin, Rahman Khakban, Donald P. Tashkin, Judith M. Vonk, Zsuszanna Hollander, Stirling Bryan, Zafar Zafari, Robert A. Wise, Stephen Lam, Dirkje S. Postma, Claes-Göran Löfdahl, Bruce M. McManus |
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| Přispěvatelé: | Groningen Research Institute for Asthma and COPD (GRIAC) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pediatrics SAMPLE Population PROTEIN AIR-FLOW OBSTRUCTION 03 medical and health sciences 0302 clinical medicine Internal medicine Linear regression Medicine COPD 030212 general & internal medicine education Lung cancer Statistic POPULATION RISK education.field_of_study Lung business.industry Regression analysis General Medicine NATURAL-HISTORY medicine.disease respiratory tract diseases Clinical trial medicine.anatomical_structure 030228 respiratory system Cardiology HEALTH SMOKING business |
| Zdroj: | Canadian Medical Association Journal, 188(14), 1004-1011. CMA-CANADIAN MEDICAL ASSOC |
| ISSN: | 0820-3946 |
| DOI: | 10.1503/cmaj.151483 |
| Popis: | Background: The rate of lung-function decline in chronic obstructive pulmonary disease (COPD) varies substantially among individuals. We sought to develop and validate an individualized prediction model for forced expiratory volume at 1 second (FEV1) in current smokers with mild-to-moderate COPD.Methods: Using data from a large long-term clinical trial (the Lung Health Study), we derived mixed-effects regression models to predict future FEV1 values over 11 years according to clinical traits. We modelled heterogeneity by allowing regression coefficients to vary across individuals. Two independent cohorts with COPD were used for validating the equations.Results: We used data from 5594 patients (mean age 48.4 yr, 63% men, mean baseline FEV1 2.75 L) to create the individualized prediction equations. There was significant between-individual variability in the rate of FEV1 decline, with the interval for the annual rate of decline that contained 95% of individuals being -124 to -15 mL/yr for smokers and -83 to 15 mL/yr for sustained quitters. Clinical variables in the final model explained 88% of variation around follow-up FEV1. The C statistic for predicting severity grades was 0.90. Prediction equations performed robustly in the 2 external data sets.Interpretation: A substantial part of individual variation in FEV1 decline can be explained by easily measured clinical variables. The model developed in this work can be used for prediction of future lung health in patients with mild-to-moderate COPD.Trial registration: Lung Health Study ClinicalTrials.gov, no. NCT00000568; Pan-Canadian Early Detection of Lung Cancer Study ClinicalTrials.gov, no. NCT00751660 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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