Preview of Abstract # 852666
European Respiratory Society
Annual Congress 2013
Abstract Number: 852666
Contact/Presenting Author: Dr. Rupert Jones
Department/Institution: Primary Care, Pensinsula School of Medicine and Dentistry
Address: 1 Davy Rd (N21)
City/State/Zip/Country: Plymouth, Devon, PL6 8BX, United Kingdom
Phone: 00447974975389
00447974975389 FREE
Fax: Email: rupert.jones@pms.ac.ukDate of Birth (dd/mm/yyyy): 18/04/1955
Is the presenting author a Medical Doctor (MD)? Yes
ERS Membership Number:
Other Memberships:
None Indicated
Abstract Group: 1.6. General Practice and Primary Care
Keyword 1: COPD - management Keyword 2: Primary care Keyword 3: Exacerbation
PRESENTATION TYPE: No preference selected.
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General Conflicts of Interests: The Presenting Author has the following, real or perceived, conflicts
of interest that relate to this abstract.
The study was sponsored by the International Primary Care Respiratory Group
Tobacco-Industry related conflict of interests: I have NO relationship of any kind with the
tobacco industry (since 1/1/2000) nor will have a link to the tobacco industry before the event to which
I have been invited by the ERS to participate in
Title: A comparison of multi-component indices of COPD severity in primary care: an UNLOCK study
from the IPCRG
Dr. Rupert Jones, rupert.jones@pms.ac.uk, MD1, David Price, david@respiratoryresearch.org, MD2,
Niels Chavannes, N.H.Chavannes@lumc.nl, MD3, Prof. Amanda Lee, a.j.lee@abdn.ac.uk4, Elizabeth
Gabe-Thomas, E.G.Thomas@bath.ac.uk1, Bjorn Stallberg, b.stallberg@salem.mail.telia.com, MD5, Karin
Lisspers, k.lisspers@alfa.telenordia.se, MD5 and Josefin Sundh, josefin.sundh@orebroll.se6. 1Peninsula
School of Medicine and Dentistry, University of Plymouth, Plymouth, United Kingdom; 2Centre of
Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom; 3Department of Public
Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands; 4Medical Statistics
Team, University of Aberdeen, Aberdeen, United Kingdom, AB25 2ZD; 5Department of Public Health
and Caring Sciences, Uppsala University, Uppsala, Sweden and 6School of Health and Medical Science,
Orebro University, Orebro, Sweden.
Body: Objective: To compare the DOSE and ADO indices with a range of outcomes across multiple
COPD populations, as gauges of COPD severity.
Design: Real-life observational cohort study.
Study population: 5486 primary care COPD patients : 4400 in the Optimal Patient Care database;
370 in Devon UK; 154 in a pulmonary rehabilitation programme rehabilitation in Holland; 562 in
PRAXIS-study, Sweden.
Main outcome measures: DOSE and ADO associations with CCQ and SGRQ; current and future
exacerbations and hospital admissions and mortality.
Results: Both DOSE and ADO indices inversely correlated with CCQ and SGRQ (p<0.001), DOSE was
stronger across all items and with healthcare consumption markers (treatment-defined exacerbations,
out of hours general practitioner visits and hospital admissions). DOSE, but not ADO, predicted future
exacerbations and admissions. Both indices predicted mortality, ADO was the stronger of the two.
Table 1: Rank correlations of DOSE and ADO indices with health status, exacerbations and future
hospital admissions
Study
Outcome Measure
DOSE index P-value ADO index P-value
Bocholtz (n=154)
Health Status (CCQ score)
-0.55
<0.001 -0.41
<0.001
PRAXIS-cohort (n=562)
Health Status (CCQ score)
-0.71
<0.001 -0.62
<0.001
Devon Audit (n=370)
Current exacerbations
0.52
<0.001 0.08
0.127
OPC (n=4400)
Current exacerbations
0.47
<0.001 0.10
<0.001
OPC (n=4400)
Future hospital admissions
0.09
<0.001 0.04
0.004
Conclusions: The DOSE index is better than the ADO index for predicting a wide range of outcomes in
a diversity of COPD patients. The DOSE index is suitable a tool in routine clinical practice to identify
those with current symptoms and future risk of exacerbations, admissions and mortality