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

Rupert C Jones, David Price, Niels H Chavannes, Amanda J Lee, Michael E Hyland, Björn Ställberg, Karin Lisspers, Josefin Sundh, Thys van der Molen & Ioanna Tsiligianni

A recent publication in the Primary Care Respiratory Medicine Journal compared different multi-component assessments of COPD as predictors for exacerbations and mortality. The study compared the BODE, DOSE and ADO Indexes with the Gold Categorization system in three databases spread across the UK, Sweden and Holland (the UK database being OPCRD). It concludes that;

‘When assessing patients in clinical practice, whether for quality improvement audits or for reporting patient status in primary and secondary care, we would concur with the NICE guidelines that the BODE index is the index of choice when 6MWT data are available. When the 6MWT is not available, the DOSE index is preferable to the ADO index for assessing current symptoms and future risk of exacerbations and hospitalisations. The risk of mortality is better predicted by the ADO or BODE indices than by the GOLD categories and the DOSE index. Given that the GOLD categories when calculated by the alternative methods produced greatly varying populations and variable value in predicting risk, they cannot be recommended for routine care or treatment decisions.’

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ACM