Exacerbation (utility# measured with visual analogue scale¶) | 0.259–0.580/0.462 (0.453–0.471)#### | 1991/8#### | +++− Moderate certainty due to inconsistency#### | Most people find exacerbation of COPD probably has a large impact on their lives. There is probably no important variability for this assessment. |
Exacerbation (EQ-5D utility+) | 0.430–0.683/0.519 (0.502–0.537)¶¶¶¶ | 927/3¶¶¶¶ | ++−− Low certainty due to inconsistency and indirectness¶¶¶¶,###### | Most people find exacerbation of COPD probably has a large impact on their lives. There is probably no important variability for this assessment. |
Exacerbation (disutility)§ | Visual analogue scale 1 nonserious exacerbation: −0.037 (0.005) 2 nonserious exacerbations: −0.068 (0.005) 1 serious exacerbation: −0.090 (0.007) 1 nonserious and 1 serious exacerbation: −0.130 (0.007) Time trade off 1 nonserious exacerbation: −0.010 (0.007) 2 nonserious exacerbations: −0.021 (0.007) 1 serious exacerbation: −0.042 (0.009) 1 nonserious and 1 serious exacerbation: −0.088 (0.009) | 239/1 | ++++ High certainty | Most people find exacerbation of COPD has an impact on their lives, which grows larger as the severity of exacerbation progresses. There is probably no important variability for this assessment. |
Level 1 dyspnoea (utility measured with visual analogue scale)ƒ | 0.751 | 146/1ƒ | ++++ High certaintyƒ | Most people find level 1 dyspnoea has a small to moderate impact on lives. There is probably no important variability for this assessment. |
Level 2 dyspnoea (utility measured with visual analogue scale)ƒ | 0.656 | 45/1ƒ | +++− Moderate certainty due to imprecisionƒ | Most people find level 2 dyspnoea probably has a moderate impact on lives. There is probably no important variability for this assessment. |
Level 3 dyspnoea (utility measured with visual analogue scale)ƒ | 0.526 | 7/1ƒ | ++−− Low certainty due to very serious imprecisionƒ | Most people find level 3 dyspnoea probably has a large impact on lives. There is probably no important variability for this assessment. |
Adverse events (discrete choice)## | Two studies suggested that patients consider adverse events as important outcomes. One study suggested adverse events were more important than onset time of medicine, ease of use, rescue medicine use. Another suggested adverse events were more important than costs of treatment, extent to which the patient sees the same doctor each time and extent to which the doctor treats the patient as an entire person. Both studies concluded symptom relief to be more important than adverse events. | 564/2 | +++− Moderate certainty due to risk of bias## | People probably consider adverse events as an important outcome. There is likely no important variability for this assessment. |
Extent of symptom relief (discrete choice)## | Two studies compared extend of symptom relief with other outcomes. Extent of symptom relief was considered the most important outcome in these two studies. | 564/2 | +++− Moderate certainty due to risk of bias## | Most people probably find symptom relief as important outcome. There is probably no important variability for this assessment. |
Extent of symptom relief (forced choice)¶¶ | In a survey on expectation of treatment, greater symptomatic relief was chosen by 82.3% of the participants, thus the most important outcome. Extent of symptom relief was considered the second most important outcome in one cross-sectional study (less preferred “not to be kept alive on life support when there is little hope for a meaningful recovery”). Another study reported 58.0% of the participants would prefer treatment focusing on relieving pain and discomfort rather than extending life. | 1640/3 | +++− Moderate certainty due to risk of bias¶¶ | Most people probably find symptom relief as important outcome. There is probably no important variability for this assessment. |
Very severe COPD (utility measured with visual analogue scale)++ | 0.321–0.651/0.345 (0.335–0.354)++++ | 746/7 | ++−− Low certainty due to risk of bias++++++ and inconsistency++ | Most people find very severe COPD seems to have a large impact on lives. There is probably important variability for this assessment. |
Very severe COPD (EQ-5D utility)§§ | 0.520–0.740/0.681 (0.667–0.694)§§§§ | 898/10 | +++− Moderate certainty due to inconsistency§§§§ | Most people find very severe COPD probably has a large impact on lives. There is probably important variability for this assessment. |
Severe COPD (utility measured with visual analogue scale)ƒƒ | 0.446–0.689/0.508 (0.501–0.515)ƒƒƒƒ | 4683/8 | ++−− Low certainty due to risk of bias++++++ and inconsistency ƒƒƒƒ | Most people find severe COPD probably has a moderate to large impact on lives. There is probably important variability for this assessment. |
Severe COPD (EQ-5D utility)### | 0.620–0.810/0.741 (0.734–0.749)##### | 4352/11 | +++− Moderate certainty due to inconsistency##### | Most people find severe COPD probably has a moderate to large impact on lives. There is probably important variability for this assessment. |
Moderate COPD (utility measured with visual analogue scale)¶¶¶ | 0.589–0.726/0.639 (0.635–0.642)¶¶¶¶¶ | 9664/10 | ++−− Low certainty due to risk of bias++++++ and inconsistency¶¶¶¶¶ | Most people find moderate COPD probably has a moderate impact on lives. There is probably important variability for this assessment. |
Moderate COPD (EQ-5D utility)+++ | 0.680–0.890/0.821 (0.815–0.826)+++++ | 4620/9 | +++− Moderate certainty due to inconsistency+++++ | Most people find moderate COPD probably has a moderate impact on lives. There is probably important variability for this assessment. |
Mild COPD (utility measured with visual analogue scale)§§§ | 0.680–0.811/0.738 (0.732-0.746)§§§§§ | 3623/8 | ++−− Low certainty due to risk of bias++++++ and inconsistency§§§§§ | Most people find moderate COPD probably has a small to moderate impact on lives. There is likely important variability for this assessment. |
Mild COPD (EQ-5D utility)ƒƒƒ | 0.770–0.900/0.873 (0.863–0.883)ƒƒƒƒƒ | 2067/7 | +++− Moderate certainty due to inconsistency ƒƒƒƒƒ | Most people find moderate COPD probably has a small to moderate impact on lives. There is probably important variability for this assessment. |