Development and validation of a survey-based COPD severity score
Development and validation of a survey-based COPD severity score
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DOI：
10.1378/chest.127.6.1890
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发表时间：
2005-06-01
期刊：
影响因子：
9.6
通讯作者：
Blanc, PD
中科院分区：
文献类型：
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作者：
Eisner, MD;Trupin, L;Blanc, PD
目的：为基于调查的流行病学研究开发一种综合疾病特异性COPD严重程度量表。使用基于人群的383名美国成年人的样本，他们自我报告医生诊断为COPD，我们开发了一种疾病特异性COPD严重程度工具。严重程度评分基于结构化电话访谈回答，包括COPD严重程度的五个总体方面：呼吸系统症状、全身性皮质类固醇使用、其他COPD药物使用、既往住院或插管和家庭氧气使用。我们通过检查COPD严重程度评分与三个健康状况领域（肺功能、身体健康相关生活质量（HRQL）和身体残疾）之间的相关性来评估并行有效性。结果：COPD严重程度评分具有较高的内部一致性信度（Cronbach α = 0.80）。在49例有FEV 1数据的受试者中，COPD严重程度评分越高，预测FEV 1的百分比越低（r =-0.40，p = 0.005）。在93名有PEFR测量结果的受试者中，COPD严重程度越高，预测PEFR的百分比越差（r =-0.35，p < 0.001）。COPD严重程度评分越高，身体HRQL越差（r =-0.58，p < 0.0001），呼吸系统疾病导致活动受限越多（r = 0.59，p < 0.0001）。COPD严重程度评分越高，日常生活活动困难的风险越大（比值比[OR]，2.3; 95%可信区间[CI]，1.8 ~ 3.0），工作能力丧失的风险越大（OR，4.2; 95% CI，3.0 ~ 5.8）。COPD严重程度评分是一种可靠有效的疾病严重程度测量方法，使其成为一种有用的研究工具。不需要肺功能测量的严重程度评分可用作研究结果或调整疾病严重程度。
Objective: To develop a comprehensive disease-specific COPD severity instrument for survey-based epidemiologic research.Study design and setting. Using a population-based sample of 383 US adults with self-reported physician diagnosed COPD, we developed a disease-specific COPD severity instrument. The severity score was based on structured telephone interview responses and included five overall aspects of COPD severity: respiratory symptoms, systemic corticosteroid use, other COPD medication use, previous hospitalization or intubation, and home oxygen use. We evaluated concurrent validity by examining the association between the COPD severity score and three health status domains: pulmonary function, physical health-related quality of life (HRQL), and physical disability. Pulmonary function was available for a subgroup of the sample (FEV1, n = 49; peak expiratory flow rate [PEFR], n = 93).Results: The COPD severity score had high internal consistency reliability (Cronbach alpha = 0.80). Among the 49 subjects with FEV1 data, higher COPD severity scores were associated with poorer percentage of predicted FEV1 (r = - 0.40, p = 0.005). In the 93 subjects with available PEFR measurements, greater COPD severity was also related to worse percentage of predicted PEFR (r = - 0.35, p < 0.001). Higher COPD severity scores were strongly associated with poorer physical HRQL (r = - 0.58, p < 0.0001) and greater restricted activity attributed to a respiratory condition (r = 0.59, p < 0.0001). Higher COPD severity scores were also associated with a greater risk of difficulty with activities of daily living (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.8 to 3.0) and inability to work (OR, 4.2; 95% CI, 3.0 to 5.8).Conclusion. The COPD severity score is a reliable and valid measure of disease severity, making it a useful research tool. The severity score, which does not require pulmonary function measurement, can be used as a study outcome or to adjust for disease severity.