Open AccessNew GOLD classification: longitudinal data on group assignment
Author(s) -
Ciro Casanova,
Alicia Marín,
Cristina Martínez-González,
Pilar de Lucas-Ramos,
Isabel Mir-Viladrich,
Borja G. Cosío,
Germán Peces-Barba,
Myriam Calle Rubio,
Ingrid Solanes-García,
Ramón Agüero,
Alfredo de Diego-Damia,
Nuria Feu-Collado,
Inmaculada Alfageme,
Rosa Irigaray,
Eva Balcells,
Antonia Llunell,
Juan B. Gáldiz,
Marta Marín,
Juan José Soler-Cataluña,
José Luís López-Campos,
Joan B. Soriano,
Juan P. de-Torres
Publication year - 2014
Publication title -
respiratory research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.846
H-Index - 104
eISSN - 1465-993X
pISSN - 1465-9921
DOI - 10.1186/1465-9921-15-3
Subject(s) - copd , medicine , spirometry , observational study , gold standard (test) , bode index , cohort , pulmonary disease , physical therapy , asthma , pulmonary rehabilitation
Rationale Little is known about the longitudinal changes associated with using the 2013 update of the multidimensional GOLD strategy for chronic obstructive pulmonary disease (COPD). Objective To determine the COPD patient distribution of the new GOLD proposal and evaluate how this classification changes over one year compared with the previous GOLD staging based on spirometry only. Methods We analyzed data from the CHAIN study, a multicenter observational Spanish cohort of COPD patients who are monitored annually. Categories were defined according to the proposed GOLD: FEV 1 %, mMRC dyspnea, COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and exacerbations-hospitalizations. One-year follow-up information was available for all variables except CCQ data. Results At baseline, 828 stable COPD patients were evaluated. On the basis of mMRC dyspnea versus CAT, the patients were distributed as follows: 38.2% vs. 27.2% in group A, 17.6% vs. 28.3% in group B, 15.8% vs. 12.9% in group C, and 28.4% vs. 31.6% in group D. Information was available for 526 patients at one year: 64.2% of patients remained in the same group but groups C and D show different degrees of variability. The annual progression by group was mainly associated with one-year changes in CAT scores (RR, 1.138; 95%CI: 1.074-1.206) and BODE index values (RR, 2.012; 95%CI: 1.487-2.722). Conclusions In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index.