Online Supplement
In this online supplement we present analogs of Table 4 and Figures 1-3 from the main paper but
using pre-bronchodilator spirometry; we have labeled them as figures E1-E3 and table E4. We
also present a listing of the BOLD Collaborative Research Group, and acknowledgments to our
many supporters.
Legends for Figures
Figure E1.
Comparison of COPD prevalence for various alternative definitions of COPD
using pre-bronchodilator spirometry for participants in the BOLD study. Top panel contrasts
prevalences for each definition within site, while bottom panel contrasts site differences within
each definition. Prevalences based on the fixed ratio significantly higher than for all other
estimators at each site (all p-values <0.001)
Figure E2.
Prevalence of “COPD” among healthy never smokers in the BOLD study (using
pre-bronchodilator spirometry data from all sites combined). Except for the LLN(ratio) criterion
for the lowest age group (p=0.14), the fixed ratio prevalence estimates were all significantly
greater than those for each of the other estimators (p<0.0001).
Figure E3.
Prevalence of GOLD stages 2-4 COPD in the BOLD study using NHANES III
and site specific prediction equations (using pre-bronchodilator spirometry data from all sites
combined). The estimated prevalences were significantly higher (p<0.0001 for all age groups)
when using common reference equations for all sites (NHANES and Hordaland County) than
when using local prediction equations. The NHANES and Hordaland County prevalence
estimates differed significantly overall and for the youngest and oldest age groups.
Table E4.
Prevalence of COPD1 Computed Using FEV1/FEV6 in place of the FEV1/FVC
Overall
Age (years)
40-49
50-59
60-69
70+
Packyears
never smoker
0-10
10-20
20+
Gender
Male
Female
Site
Guangzhou
Adana
Salzburg
CapeTown
Reykjavik
Hanover
Krakow
Bergen
Vancouver
Lexington
Manila
Sydney
London
Uppsala
N
9823
COPD Criterion
LLN(FEV1/FEV6)
LLN(FEV1/FVC)
and FEV1,%<80
and FEV1,%<80
10.9%
11.5%
P-value2
<.01
3343
2923
2106
1451
6.9%
9.3%
13.9%
19.2%
7.0%
10.1%
15.3%
19.0%
.44
<.01
<.01
.88
4199
1756
1258
2601
6.2%
8.4%
12.5%
19.5%
6.7%
8.1%
13.0%
20.9%
.03
.56
.31
<.01
4697
5126
11.7%
10.2%
12.3%
10.7%
<.01
<.01
480
801
1221
810
748
681
493
649
832
475
892
532
680
529
8.5%
11.2%
10.5%
20.5%
10.0%
7.0%
9.9%
9.7%
7.0%
14.3%
13.0%
9.2%
12.4%
7.0%
7.7%
12.5%
11.4%
20.5%
12.2%
7.5%
11.4%
9.9%
7.7%
15.4%
11.9%
9.8%
13.2%
7.8%
.29
.01
.02
1.0
<.01
.55
.07
1.0
.15
.12
.03
.55
.15
.29
1
Data are univariate classifications based on pre-bronchodilator spirometry and not adjusted
for other terms in the table.
2
two-tailed exact p-values based on McNemar’s test for comparing prevalences within each
subgroup.
The Burden of Obstructive Lung Disease (BOLD) Collaborative Research Group
Executive Committee – A. Sonia Buist, chair (Oregon Health and Sciences University, Portland,
OR, USA); Peter Burney (National Heart and Lung Institute, Imperial College, London, UK);
Todd Lee (Northwestern University, Chicago, IL, USA); David M. Mannino (University of
Kentucky, Lexington, KY, USA); Mary Ann McBurnie (Kaiser Permanente Center for Health
Research, Portland, OR, USA); Ana MB Menezes (Federal University of Pelotas, Brazil); Sean
Sullivan (University of Washington, Seattle, WA, USA); Jørgen Vestbo (Hvidovre University
Hospital, Hvidovre, Denmark); William M. Vollmer (Kaiser Permanente Center for Health
Research, Portland, OR, USA); Kevin B. Weiss (Northwestern University, Chicago, IL, USA).
International Advisory Board – Amund Gulsvik, chair (University of Bergen, Bergen, Norway);
Josep M Antó (Centre for Research in Environmental Epidemiology [CREAL, IMIM], Institut
Municipal d’Investigació Mèdica (IMIM), Spain); Robert Crapo (Latter Day Saints Hospital,
Salt Lake City, UT, USA); Guy Marks (Woolcock Institute of Medical Research, Sydney,
Australia); Rogelio Perez-Padilla (Instituto Nacional de Enfermedades Respiratorias, Mexico
City, Mexico); Gregory R. Wagner (CDC/NIOSH, Washington, DC, USA)
Operations Center – William M. Vollmer (PI), Michael Allison, Paul Cheek, Linda Figurski, E.
Ann Frazier, Suzanne Gillespie, Chris Kelleher, Terry Kimes, Nidhi Kochar, Mary Ann
McBurnie, Gayle Thomas-Monk, Esma Vance (Kaiser Permanente Center for Health Research,
Portland, OR, USA); A. Sonia Buist (Oregon Health and Sciences University, Portland, OR,
USA); Virginia Lesser (Oregon State University)
Economics Core – Todd Lee and Kevin B. Weiss (Northwestern University, Chicago, IL, USA);
Sean D. Sullivan, (University of Washington, Seattle, WA, USA);
Pulmonary Function Reading Center – Bob Crapo, Robert Jenson (Latter Day Saints Hospital,
Salt Lake City, UT, USA)
Field Centers – NanShan Zhong (PI), Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang,
Jingping Zheng, Yumin Zhou (Guangzhou Institute of Respiratory Diseases, Guangzhou
Medical College, Guangzhou, China); Ali Kocabaş (PI), Attila Hancioglu, Ismail Hanta, Sedat
Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan (Cukurova University School of
Medicine, Department of Chest Diseases, Adana, Turkey); Michael Studnicka (PI), Torkil
Dawes, Bernd Lamprecht, Lea Schirhofer (Paracelsus Medical University, Department of
Pulmonary Medicine, Salzburg Austria); Eric Bateman (PI), Anamika Jithoo (PI), Desiree
Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen,
Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck,
(University of Cape Town Lung Institute, Cape Town, South Africa); Thorarinn Gislason (PI),
Bryndis Benedikdtsdottir, Kristin Börundsdottir, Lovisa Gudmundsdottir, Sigrun
Gudmundsdottir, Gunnar Gundmundsson, (Landspitali University Hospital, Dept. of Allergy,
Respiratory Medicine and Sleep, Reykjavik, Iceland); Ewa Nizankowska-Mogilnicka (PI) ,
Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej
Szczeklik,Magda Twardowska, (Division of Pulmonary Diseases, Department of Medicine,
Jagiellonian University School of Medicine, Cracow, Poland); Tobias Welte (PI), Isabelle
Bodemann, Henning Geldmacher, Alexandra Schweda-Linow (Hannover Medical School,
Hannover, Germany); Amund Gulsvik (PI), Tina Endresen, Lene Svendsen (Department of
Thoracic Medicine, Institute of Medicine, University of Bergen, Bergen, Norway); Wan C. Tan
(PI), Wen Wang (iCapture Center for Cardiovascular and Pulmonary Research, University of
British Columbia, Vancouver, BC, Canada); David M. Mannino (PI), John Cain, Rebecca
Copeland, Dana Hazen, Jennifer Methvin, (University of Kentucky, Lexington, Kentucky,
USA); Renato B. Dantes (PI), Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez,
Norberto A. Francisco, Gerard S. Garcia, Teresita S. de Guia, Luisito F. Idolor, Sullian S. Naval,
Thessa Reyes, Camilo C. Roa, Jr., Ma. Flordeliza Sanchez, Leander P. Simpao (Philippine
College of Chest Physicians, Manila, Philippines); Christine Jenkins (PI), Guy Marks (PI),
Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle (Woolcock Institute of Medical
Research, Sydney, Australia); Christer Janson (PI), Inga Sif Olafsdottir, Katarina Nisser, Ulrike
Spetz Nyström, Gunilla Hägg, Gun-Marie Bodman Lund (Department of Medical Sciences:
Respiratory Medicine & Allergology, Uppsala university, Uppsala, Sweden); Peter Burney (PI),
Caron Amor, James Potts, Michael Tumilty, Fiona McLean (National Heart and Lung Institute,
Imperial College, London).
Funding Acknowledgments
The BOLD initiative has been funded in part by unrestricted educational grants to the Operations
Center (www.boldcopd.org) from ALTANA, Aventis, AstraZeneca, Boehringer-Ingelheim,
Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor, and University of
Kentucky.
Additional local support for BOLD clinical sites was provided by: Boehringer Ingelheim China.
(GuangZhou, China ); Turkish Thoracic Society, Boehringer-Ingelheim, and Pfizer (Adana,
Turkey ); Altana, Astra-Zeneca, Boehringer-Ingelheim, GlaxoSmithKline, Merck Sharpe &
Dohme, Novartis, Salzburger Gebietskrankenkasse and Salzburg Local Government (Salzburg,
Austria ); Research for International Tobacco Control, the International Development Research
Centre, the South African Medical Research Council, the South African Thoracic Society
GlaxoSmithKline Pulmonary Research Fellowship, and the University of Cape Town Lung
Institute (Cape Town, South Africa ); and Landspitali University Hospital Research Fund,
GlaxoSmithKline Iceland, and AstraZeneca Iceland (Reykjavik, Iceland ); GlaxoSmithKline
Pharmaceuticals, Polpharma, Ivax Pharma Poland, AstraZeneca Pharma Poland, ZF Altana
Pharma, Pliva Kraków, Adamed, Novartis Poland, Linde Gaz Polska, Lek Polska,
Tarchomińskie Zakłady Farmaceutyczne Polfa, Starostwo Proszowice, Skanska, Zasada,
Agencja Mienia Wojskowego w Krakowie, Telekomunikacja Polska, Biernacki, Biogran,
Amplus Bucki, Skrzydlewski, Sotwin, and Agroplon (Cracow, Poland); Boehringer-Ingelheim,
and Pfizer Germany (Hannover, Germany ); the Norwegian Ministry of Health’s Foundation for
Clinical Research, and Haukeland University Hospital’s Medical Research Foundation for
Thoracic Medicine (Bergen, Norway); AstraZeneca, Boehringer-Ingelheim, Pfizer, and
GlaxoSmithKline (Vancouver, Canada); Marty Driesler Cancer Project (Lexington, Kentucky,
USA); Altana, Boehringer Ingelheim (Phil), GlaxoSmithKline, Pfizer, Philippine College of
Chest Physicians, Philippine College of Physicians, and United Laboratories (Phil) (Manila,
Philippines); Air Liquide Healthcare P/L, AstraZeneca P/L, Boehringer Ingelheim P/L,
GlaxoSmithKline Australia P/L, Pfizer Australia P/L (Sydney, Australia); Swedish Heart Lung
Foundation, Swedish Association Against Heart and Lung Diseases, Bror Hjerstedt Foundation,
GlaxoSmithKline Sweden (Uppsala, Sweden); Department of Health Policy Research
Programme (London, United Kingdom).