uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Multi-component assessment of chronic obstructive pulmonary disease: an evaluation of the ADO and DOSE indices and the global obstructive lung disease categories in international primary care data sets
Univ Plymouth, Peninsula Sch Med, Clin Trials & Populat Studies, ITTC Bldg N14,Plymouth Sci Pk, Plymouth PL4 8AA, Devon, England.;Univ Plymouth, Peninsula Sch Dent, Clin Trials & Populat Studies, ITTC Bldg N14,Plymouth Sci Pk, Plymouth PL4 8AA, Devon, England..
Univ Aberdeen, Ctr Acad Primary Care, Aberdeen, Scotland..
Leiden Univ, Med Ctr, Dept Publ Hlth & Primary Care, Leiden, Netherlands..
Univ Aberdeen, Appl Hlth Sci, Med Stat Team, Aberdeen, Scotland..
Show others and affiliations
2016 (English)In: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 26, 16010Article in journal (Refereed) PublishedText
Abstract [en]

Suitable tools for assessing the severity of chronic obstructive pulmonary disease (COPD) include multi-component indices and the global initiative for chronic obstructive lung disease (GOLD) categories. The aim of this study was to evaluate the dyspnoea, obstruction, smoking, exacerbation (DOSE) and the age, dyspnoea, obstruction (ADO) indices and GOLD categories as measures of current health status and future outcomes in COPD patients. This was an observational cohort study comprising 5,114 primary care COPD patients across three databases from UK, Sweden and Holland. The associations of DOSE and ADO indices with (i) health status using the Clinical COPD Questionnaire (CCQ) and St George's Respiratory Questionnaire (SGRQ) and COPD Assessment test (CAT) and with (ii) current and future exacerbations, admissions and mortality were assessed in GOLD categories and DOSE and ADO indices. DOSE and ADO indices were significant predictors of future exacerbations: incident rate ratio was 1.52 (95% confidence intervals 1.46-1.57) for DOSE, 1.16 (1.12-1.20) for ADO index and 1.50 (1.33-1.68) and 1.23 (1.10-1.39), respectively, for hospitalisations. Negative binomial regression showed that the DOSE index was a better predictor of future admissions than were its component items. The hazard ratios for mortality were generally higher for ADO index groups than for DOSE index groups. The GOLD categories produced widely differing assessments for future exacerbation risk or for hospitalisation depending on the methods used to calculate them. None of the assessment systems were excellent at predicting future risk in COPD; the DOSE index appears better than the ADO index for predicting many outcomes, but not mortality. The GOLD categories predict future risk inconsistently. The DOSE index and the GOLD categories using exacerbation frequency may be used to identify those at high risk for exacerbations and admissions.

Place, publisher, year, edition, pages
2016. Vol. 26, 16010
National Category
Family Medicine Respiratory Medicine and Allergy
URN: urn:nbn:se:uu:diva-297373DOI: 10.1038/npjpcrm.2016.10ISI: 000375122000002PubMedID: 27053297OAI: oai:DiVA.org:uu-297373DiVA: diva2:941661
Available from: 2016-06-22 Created: 2016-06-22 Last updated: 2016-06-22Bibliographically approved

Open Access in DiVA

fulltext(636 kB)38 downloads
File information
File name FULLTEXT01.pdfFile size 636 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Ställberg, BjörnLisspers, Karin
By organisation
Family Medicine and Preventive Medicine
In the same journal
Primary Care Respiratory Journal
Family MedicineRespiratory Medicine and Allergy

Search outside of DiVA

GoogleGoogle Scholar
Total: 38 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 95 hits
ReferencesLink to record
Permanent link

Direct link