Abstract
The 2011 Global Initiative for chronic obstructive lung disease (GOLD) guidelines recommend a combined assessment for measuring the impact of COPD which considers current symptoms and future exacerbation risk (A: low risk, less symptoms; B: low risk, more symptoms; C: high risk, less symptoms; D: high risk, more symptoms). Two symptom cut-points are proposed: COPD Assessment Test (CAT) score ≥10 and modified Medical Research Council Dyspnoea (mMRC) score ≥2.
This analysis examined health status scores split by these cut-points, using CAT and mMRC data together with SGRQ and SF-12 Physical Function (PC) scores, in a primary care population from the Health Related Quality of Life in European COPD Study.
Data from 1817 patients (mean [SD] FEV1 1.6 [0.6] L; age 64.9 [9.6] years; males 72%) could be used. The SGRQ and SF-12PC scores are tabulated. The mMRC classified 57.2% patients as having low symptoms versus 17.2% with the CAT. The distribution of low symptom patients into low risk and high risk categories differed. Patients categorised by mMRC as having low symptoms (Groups A & C) had much higher SGRQ scores (>3 times the minimum clinically important difference) than those categorised by CAT.
The mMRC cut-point of ≥ 2 classified a high proportion of these patients as having low symptoms, despite having moderately high SGRQ scores and poor SF-12 PC scores.
- © 2012 ERS
