TY - JOUR T1 - Combined COPD assessment using the new GOLD guidelines JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 1647 AU - Alex Mackay AU - Gavin Donaldson AU - Anant Patel AU - Richa Singh AU - John Hurst AU - Jadwiga Wedzicha Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/1647.abstract N2 - GOLD guidelines advocate symptomatic assessment using the CAT or mMRC, followed by spirometry and/or exacerbation history to determine exacerbation risk (fig 1). We examined this guidance in the London COPD cohort.106 patients completed daily symptom diary cards for ≥1 year and the CAT at least once when stable. All exacerbations received additional systemic and/or inhaled therapy.Mean age was 72.6 years (SD 8.3), FEV1 1.1L (0.5), and FEV1 predicted 48.5% (16.4).Using CAT and GOLD grade to assess exacerbation risk yielded significantly more high risk patients (category C&D) than when exacerbation history was used (56.6% vs. 33.0%, p=0.001).After combined assessment using both GOLD grade and exacerbation history, few patients were included in the high risk, less symptoms category C: 8.5% (9/106) using CAT and 10.4% (11/106) using mMRC.In a specialist outpatient setting, few patients fulfil criteria for inclusion in the high risk, less symptoms category C. Furthermore, the method chosen to assess exacerbation risk had a large influence on risk stratification. Additional work is required to examine the utility of this aspect of GOLD guidance in primary care to screen for exacerbation risk. ER -