COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time.
COPD
Cluster analysis
Decision trees
Phenotype
Treatable traits
Journal
Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633
Informations de publication
Date de publication:
14 Feb 2022
14 Feb 2022
Historique:
received:
19
10
2021
accepted:
08
02
2022
entrez:
15
2
2022
pubmed:
16
2
2022
medline:
22
3
2022
Statut:
epublish
Résumé
Profiles of people with chronic obstructive pulmonary disease (COPD) often do not describe treatable traits, lack validation and/or their stability over time is unknown. We aimed to identify COPD profiles and their treatable traits based on simple and meaningful measures; to develop and validate a decision tree and to explore profile stability over time. An observational, prospective study was conducted. Clinical characteristics, lung function, symptoms, impact of the disease (COPD Assessment Test-CAT), health-related quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. A decision tree was developed and validated cross-sectionally. Stability was explored over time with the ratio between the number of timepoints that a participant was classified in the same profile and the total number of timepoints (i.e., 6). 352 people with COPD (67.4 ± 9.9 years; 78.1% male; FEV Four profiles and treatable traits were identified with simple and meaningful measures possibly available in low-resource settings. A decision tree with three commonly used variables in the routine assessment of people with COPD is now available for quick allocation to the identified profiles in clinical practice. Profiles and treatable traits may change over time in people with COPD hence, regular assessments to deliver goal-targeted personalised treatments are needed.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
Profiles of people with chronic obstructive pulmonary disease (COPD) often do not describe treatable traits, lack validation and/or their stability over time is unknown. We aimed to identify COPD profiles and their treatable traits based on simple and meaningful measures; to develop and validate a decision tree and to explore profile stability over time.
METHODS
METHODS
An observational, prospective study was conducted. Clinical characteristics, lung function, symptoms, impact of the disease (COPD Assessment Test-CAT), health-related quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. A decision tree was developed and validated cross-sectionally. Stability was explored over time with the ratio between the number of timepoints that a participant was classified in the same profile and the total number of timepoints (i.e., 6).
RESULTS
RESULTS
352 people with COPD (67.4 ± 9.9 years; 78.1% male; FEV
CONCLUSION
CONCLUSIONS
Four profiles and treatable traits were identified with simple and meaningful measures possibly available in low-resource settings. A decision tree with three commonly used variables in the routine assessment of people with COPD is now available for quick allocation to the identified profiles in clinical practice. Profiles and treatable traits may change over time in people with COPD hence, regular assessments to deliver goal-targeted personalised treatments are needed.
Identifiants
pubmed: 35164762
doi: 10.1186/s12931-022-01954-6
pii: 10.1186/s12931-022-01954-6
pmc: PMC8842856
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
30Subventions
Organisme : Fundação para a Ciência e a Tecnologia
ID : PTDC/SAU-SER/28806/2017
Organisme : Fundação para a Ciência e Tecnologia
ID : PTDC/DTP-PIC/2284/2014
Informations de copyright
© 2022. The Author(s).
Références
ERJ Open Res. 2020 Nov 02;6(4):
pubmed: 33263050
Lung. 2019 Feb;197(1):37-45
pubmed: 30430249
Am J Respir Crit Care Med. 2013 Apr 1;187(7):728-35
pubmed: 23392440
Arch Phys Med Rehabil. 1997 Jan;78(1):26-32
pubmed: 9014953
Can J Cardiol. 2016 Apr;32(4):495-504
pubmed: 26995692
Cochrane Database Syst Rev. 2019 Mar 06;3:CD012347
pubmed: 30838649
J Cardiopulm Rehabil Prev. 2019 Jan;39(1):2-8
pubmed: 30489442
Theriogenology. 2010 Jun;73(9):1167-79
pubmed: 20138353
J Am Med Dir Assoc. 2017 Dec 1;18(12):1097.e11-1097.e24
pubmed: 29169740
Am J Respir Crit Care Med. 2015 Dec 1;192(11):1373-86
pubmed: 26623686
Braz J Phys Ther. 2016 Sep 12;20(6):517-524
pubmed: 27683835
Med Sci Sports Exerc. 2015 Oct;47(10):2053-61
pubmed: 26378942
Am J Clin Nutr. 2012 Jun;95(6):1385-95
pubmed: 22513295
Thorax. 2014 Sep;69(9):857-64
pubmed: 24781218
Eur Respir J. 2014 Dec;44(6):1504-20
pubmed: 25234804
Eur Respir J. 2014 Mar;43(3):745-53
pubmed: 24072210
PLoS One. 2016 Sep 09;11(9):e0161710
pubmed: 27611911
Br J Sports Med. 2005 May;39(5):294-7; discussion 294-7
pubmed: 15849294
Cochrane Database Syst Rev. 2017 Aug 04;8:CD011682
pubmed: 28777450
Thorax. 1999 Jul;54(7):581-6
pubmed: 10377201
Eur Respir J. 2018 Jan 31;51(2):
pubmed: 29386337
PLoS One. 2018 Sep 12;13(9):e0201593
pubmed: 30208035
ERJ Open Res. 2021 May 31;7(2):
pubmed: 34084787
Eur Respir J. 2019 May 9;53(5):
pubmed: 30846468
Medicine (Baltimore). 2016 Jul;95(28):e4225
pubmed: 27428228
Respir Res. 2015 Apr 18;16:50
pubmed: 25928208
Eur Respir J. 2016 Jul;48(1):69-81
pubmed: 27103381
Sci Rep. 2020 Oct 21;10(1):17945
pubmed: 33087813
Respir Med. 1991 Sep;85 Suppl B:25-31; discussion 33-7
pubmed: 1759018
Patient Educ Couns. 2011 Nov;85(2):281-5
pubmed: 20884162
Int J Chron Obstruct Pulmon Dis. 2015 Jan 07;10:95-109
pubmed: 25609943
Chron Respir Dis. 2017 Aug;14(3):256-269
pubmed: 28774199
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
pubmed: 6880820
Eur Respir J. 2017 Nov 2;50(5):
pubmed: 29097431
Arch Bronconeumol (Engl Ed). 2021 Mar;57(3):214-223
pubmed: 33041107
BMC Pulm Med. 2011 Aug 11;11:42
pubmed: 21835018
Respir Med. 2020 Sep;171:106093
pubmed: 32745966
N Engl J Med. 2004 Mar 4;350(10):1005-12
pubmed: 14999112
Ann Am Thorac Soc. 2015 Mar;12(3):303-12
pubmed: 25642832
J Clin Med. 2019 Mar 11;8(3):
pubmed: 30862102
Int J Public Health. 2013 Dec;58(6):949-53
pubmed: 23974352
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
Respirology. 2018 May;23(5):485-491
pubmed: 29027309
J Am Med Dir Assoc. 2020 Dec;21(12):1986-1991.e3
pubmed: 32723539
Isr Med Assoc J. 2020 Oct;22(10):618-622
pubmed: 33070485
Respirology. 2016 Jul;21(5):875-82
pubmed: 26916174
Eur Respir J. 2010 Sep;36(3):531-9
pubmed: 20075045
J Clin Epidemiol. 1994 Nov;47(11):1245-51
pubmed: 7722560
Sports Med. 2020 Aug;50(8):1421-1429
pubmed: 32333261
J Clin Med. 2019 Aug 29;8(9):
pubmed: 31470678