Di Zhang, Yu Guan, Xiuxiu Zhou, Mingzi Zhang, Yu Pu, Pengchen Gu, Yi Xia, Yang Lu, Jia Chen, Wenting Tu, Kunyao Huang, Jixin Hou, Hua Yang, Chicheng Fu, Qu Fang, Chuan He, Shiyuan Liu, Li Fan
Purpose: To develop a novel method for calculating small airway resistance using computational fluid dynamics (CFD) based on CT data and evaluate its value to identify COPD. Patients and Methods: 24 subjects who underwent chest CT scans and pulmonary function tests between August 2020 and December 2020 were enrolled retrospectively. Subjects were divided into three groups: normal (10), high-risk (6), and COPD (8). The airway from the trachea down to the sixth generation of bronchioles was reconstructed by a 3D slicer. The small airway resistance (RSA) and RSA as a percentage of total airway resistance (RSA%) were calculated by CFD combined with airway resistance and FEV1 measured by pulmonary function test. A correlation analysis was conducted between RSA and pulmonary function parameters, including FEV1/FVC, FEV1% predicted, MEF50% predicted, MEF75% predicted and MMEF75/25% predicted. Results: The RSA and RSA% were significantly different among the three groups (p< 0.05) and related to FEV1/FVC (r = − 0.70, p < 0.001; r = − 0.67, p < 0.001), FEV1% predicted (r = − 0.60, p = 0.002; r = − 0.57, p = 0.004), MEF50% predicted (r = − 0.64, p = 0.001; r = − 0.64, p = 0.001), MEF75% predicted (r = − 0.71, p < 0.001; r = − 0.60, p = 0.002) and MMEF 75/25% predicted (r = − 0.64, p = 0.001; r = − 0.64, p = 0.001). Conclusion: Airway CFD is a valuable method for estimating the small airway resistance, where the derived RSA will aid in the early diagnosis of COPD.
Keywords: COPD, small airway disease, CT, fluid dynamics
{"title":"Aerodynamic Simulation of Small Airway Resistance: A New Imaging Biomarker for Chronic Obstructive Pulmonary Disease","authors":"Di Zhang, Yu Guan, Xiuxiu Zhou, Mingzi Zhang, Yu Pu, Pengchen Gu, Yi Xia, Yang Lu, Jia Chen, Wenting Tu, Kunyao Huang, Jixin Hou, Hua Yang, Chicheng Fu, Qu Fang, Chuan He, Shiyuan Liu, Li Fan","doi":"10.2147/copd.s456878","DOIUrl":"https://doi.org/10.2147/copd.s456878","url":null,"abstract":"<strong>Purpose:</strong> To develop a novel method for calculating small airway resistance using computational fluid dynamics (CFD) based on CT data and evaluate its value to identify COPD.<br/><strong>Patients and Methods:</strong> 24 subjects who underwent chest CT scans and pulmonary function tests between August 2020 and December 2020 were enrolled retrospectively. Subjects were divided into three groups: normal (10), high-risk (6), and COPD (8). The airway from the trachea down to the sixth generation of bronchioles was reconstructed by a 3D slicer. The small airway resistance (R<sub>SA</sub>) and R<sub>SA</sub> as a percentage of total airway resistance (R<sub>SA</sub>%) were calculated by CFD combined with airway resistance and FEV<sub>1</sub> measured by pulmonary function test. A correlation analysis was conducted between R<sub>SA</sub> and pulmonary function parameters, including FEV<sub>1</sub>/FVC, FEV<sub>1</sub>% predicted, MEF50% predicted, MEF75% predicted and MMEF75/25% predicted.<br/><strong>Results:</strong> The R<sub>SA</sub> and R<sub>SA</sub>% were significantly different among the three groups (p< 0.05) and related to FEV<sub>1</sub>/FVC (r = − 0.70, p < 0.001; r = − 0.67, p < 0.001), FEV<sub>1</sub>% predicted (r = − 0.60, p = 0.002; r = − 0.57, p = 0.004), MEF50% predicted (r = − 0.64, p = 0.001; r = − 0.64, p = 0.001), MEF75% predicted (r = − 0.71, p < 0.001; r = − 0.60, p = 0.002) and MMEF 75/25% predicted (r = − 0.64, p = 0.001; r = − 0.64, p = 0.001).<br/><strong>Conclusion:</strong> Airway CFD is a valuable method for estimating the small airway resistance, where the derived R<sub>SA</sub> will aid in the early diagnosis of COPD.<br/><br/><strong>Keywords:</strong> COPD, small airway disease, CT, fluid dynamics<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141167220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xuan Wei, Yu Zhong, Xiaofei Yi, Tingting Li, Zhougui Ling, Moyu Ming, Shuang Zhang, Zhiyi He
Objective: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence, morbidity, and mortality. Chuankezhi (CKZ) injection, a Chinese patent medicine, has been commonly used for treating COPD. This study evaluated the clinical efficacy of CKZ injections in COPD patients and explored potential underlying mechanisms by integrating meta-analysis and network pharmacology. Research Methods: Randomized controlled trials (RCTs) were search in database by Web of Science, Cochrane Library and PubMed as of November 2022 for literature collection, and the Review Manager 5.4 was used to analyze the data. Through the network pharmacology method, the chemical components and their targets, as well as the disease targets were further analyzed. Results: A total of 15 RCTs including 1212 patients were included. The results of meta-analysis showed that CKZ injection can significantly improve the clinical effective rate (RR = 1.25, 95% CI: 1.14 to 1.36), and the clinical advantage was that it can significantly reduced acute exacerbation rate (RR = 0.29, 95% CI: 0.12 to 0.70) and COPD assessment test (CAT) scores (MD =− 4.62, 95% CI:-8.966 to-0.28). A total of 31 chemical compounds and 178 potential targets for CKZ injection were obtained from the online databases. Molecular docking revealed that most key components and targets could form stable structure. Conclusion: This systematic review with meta-analysis and network pharmacology demonstrates that CKZ could effectively improve the clinical efficacy and safety in the treatment of COPD. Such efficacy may be related to an anti-inflammatory effect and immunoregulation of CKZ via multiple components, multiple targets and multiple pathways.
{"title":"Evidence Construction of Chuankezhi Injection Against Chronic Obstructive Pulmonary Disease: A Systematic Review and Network Pharmacology","authors":"Xuan Wei, Yu Zhong, Xiaofei Yi, Tingting Li, Zhougui Ling, Moyu Ming, Shuang Zhang, Zhiyi He","doi":"10.2147/copd.s442281","DOIUrl":"https://doi.org/10.2147/copd.s442281","url":null,"abstract":"<strong>Objective:</strong> Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence, morbidity, and mortality. Chuankezhi (CKZ) injection, a Chinese patent medicine, has been commonly used for treating COPD. This study evaluated the clinical efficacy of CKZ injections in COPD patients and explored potential underlying mechanisms by integrating meta-analysis and network pharmacology.<br/><strong>Research Methods:</strong> Randomized controlled trials (RCTs) were search in database by Web of Science, Cochrane Library and PubMed as of November 2022 for literature collection, and the Review Manager 5.4 was used to analyze the data. Through the network pharmacology method, the chemical components and their targets, as well as the disease targets were further analyzed.<br/><strong>Results:</strong> A total of 15 RCTs including 1212 patients were included. The results of meta-analysis showed that CKZ injection can significantly improve the clinical effective rate (RR = 1.25, 95% CI: 1.14 to 1.36), and the clinical advantage was that it can significantly reduced acute exacerbation rate (RR = 0.29, 95% CI: 0.12 to 0.70) and COPD assessment test (CAT) scores (MD =− 4.62, 95% CI:-8.966 to-0.28). A total of 31 chemical compounds and 178 potential targets for CKZ injection were obtained from the online databases. Molecular docking revealed that most key components and targets could form stable structure.<br/><strong>Conclusion:</strong> This systematic review with meta-analysis and network pharmacology demonstrates that CKZ could effectively improve the clinical efficacy and safety in the treatment of COPD. Such efficacy may be related to an anti-inflammatory effect and immunoregulation of CKZ via multiple components, multiple targets and multiple pathways. <br/><br/><strong>Keywords:</strong> meta-analysis, network pharmacology, chronic obstructive pulmonary disease, Chuankezhi injection<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141167440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zihan Zhou, Yuhui Wang, Yongsheng Wang, Bo Yang, Chuchu Xu, Shuqin Wang, Wanchun Yang
Purpose: To develop and validate a nomogram for assessing the risk of developing hypercapnic respiratory failure (HRF) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Patients and Methods: From January 2019 to August 2023, a total of 334 AECOPD patients were enrolled in this research. We employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression to determine independent predictors and develop a nomogram. This nomogram was appraised by the area under the receiver operating characteristic curve (AUC), calibration curve, Hosmer–Lemeshow goodness-of-fit test (HL test), decision curve analysis (DCA), and clinical impact curve (CIC). The enhanced bootstrap method was used for internal validation. Results: Sex, prognostic nutritional index (PNI), hematocrit (HCT), and activities of daily living (ADL) were independent predictors of HRF in AECOPD patients. The developed nomogram based on the above predictors showed good performance. The AUCs for the training, internal, and external validation cohorts were 0.841, 0.884, and 0.852, respectively. The calibration curves and HL test showed excellent concordance. The DCA and CIC showed excellent clinical usefulness. Finally, a dynamic nomogram was developed (https://a18895635453.shinyapps.io/dynnomapp/). Conclusion: This nomogram based on sex, PNI, HCT, and ADL demonstrated high accuracy and clinical value in predicting HRF. It is a less expensive and more accessible approach to assess the risk of developing HRF in AECOPD patients, which is more suitable for primary hospitals, especially in developing countries with high COPD-related morbidity and mortality.
Keywords: acute exacerbation of chronic obstructive pulmonary disease, hypercapnic respiratory failure, nomogram, prediction model
{"title":"A Diagnostic Nomogram for Predicting Hypercapnic Respiratory Failure in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease","authors":"Zihan Zhou, Yuhui Wang, Yongsheng Wang, Bo Yang, Chuchu Xu, Shuqin Wang, Wanchun Yang","doi":"10.2147/copd.s454558","DOIUrl":"https://doi.org/10.2147/copd.s454558","url":null,"abstract":"<strong>Purpose:</strong> To develop and validate a nomogram for assessing the risk of developing hypercapnic respiratory failure (HRF) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).<br/><strong>Patients and Methods:</strong> From January 2019 to August 2023, a total of 334 AECOPD patients were enrolled in this research. We employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression to determine independent predictors and develop a nomogram. This nomogram was appraised by the area under the receiver operating characteristic curve (AUC), calibration curve, Hosmer–Lemeshow goodness-of-fit test (HL test), decision curve analysis (DCA), and clinical impact curve (CIC). The enhanced bootstrap method was used for internal validation.<br/><strong>Results:</strong> Sex, prognostic nutritional index (PNI), hematocrit (HCT), and activities of daily living (ADL) were independent predictors of HRF in AECOPD patients. The developed nomogram based on the above predictors showed good performance. The AUCs for the training, internal, and external validation cohorts were 0.841, 0.884, and 0.852, respectively. The calibration curves and HL test showed excellent concordance. The DCA and CIC showed excellent clinical usefulness. Finally, a dynamic nomogram was developed (<u>https://a18895635453.shinyapps.io/dynnomapp/</u>).<br/><strong>Conclusion:</strong> This nomogram based on sex, PNI, HCT, and ADL demonstrated high accuracy and clinical value in predicting HRF. It is a less expensive and more accessible approach to assess the risk of developing HRF in AECOPD patients, which is more suitable for primary hospitals, especially in developing countries with high COPD-related morbidity and mortality.<br/><br/><strong>Keywords:</strong> acute exacerbation of chronic obstructive pulmonary disease, hypercapnic respiratory failure, nomogram, prediction model<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141062503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Chronic Obstructive Pulmonary Disease (COPD), as one of the major global health threat diseases, particularly in China, presents a high prevalence and mortality rate. Early diagnosis is crucial for controlling disease progression and improving patient prognosis. However, due to the lack of significant early symptoms, the awareness and diagnosis rates of COPD remain low. Against this background, primary healthcare institutions play a key role in identifying high-risk groups and early diagnosis. With the development of Artificial Intelligence (AI) technology, its potential in enhancing the efficiency and accuracy of COPD screening is evident. This paper discusses the characteristics of high-risk groups for COPD, current screening methods, and the application of AI technology in various aspects of screening. It also highlights challenges in AI application, such as data privacy, algorithm accuracy, and interpretability. Suggestions for improvement, such as enhancing AI technology dissemination, improving data quality, promoting interdisciplinary cooperation, and strengthening policy and financial support, aim to further enhance the effectiveness and prospects of AI technology in COPD screening at primary healthcare institutions in China.
Keywords: chronic obstructive pulmonary disease, primary healthcare institutions, artificial intelligence, high-risk group screening, data privacy
{"title":"Application and Prospects of Artificial Intelligence Technology in Early Screening of Chronic Obstructive Pulmonary Disease at Primary Healthcare Institutions in China","authors":"Xu Yang","doi":"10.2147/copd.s458935","DOIUrl":"https://doi.org/10.2147/copd.s458935","url":null,"abstract":"<strong>Abstract:</strong> Chronic Obstructive Pulmonary Disease (COPD), as one of the major global health threat diseases, particularly in China, presents a high prevalence and mortality rate. Early diagnosis is crucial for controlling disease progression and improving patient prognosis. However, due to the lack of significant early symptoms, the awareness and diagnosis rates of COPD remain low. Against this background, primary healthcare institutions play a key role in identifying high-risk groups and early diagnosis. With the development of Artificial Intelligence (AI) technology, its potential in enhancing the efficiency and accuracy of COPD screening is evident. This paper discusses the characteristics of high-risk groups for COPD, current screening methods, and the application of AI technology in various aspects of screening. It also highlights challenges in AI application, such as data privacy, algorithm accuracy, and interpretability. Suggestions for improvement, such as enhancing AI technology dissemination, improving data quality, promoting interdisciplinary cooperation, and strengthening policy and financial support, aim to further enhance the effectiveness and prospects of AI technology in COPD screening at primary healthcare institutions in China.<br/><br/><strong>Keywords:</strong> chronic obstructive pulmonary disease, primary healthcare institutions, artificial intelligence, high-risk group screening, data privacy<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To translate a disease-specific anxiety questionnaire on chronic obstructive pulmonary disease (COPD) and test its reliability and validity in China. Patients and Methods: The German version of the revised COPD Anxiety Questionnaire (CAF-R) was initially validated using step-by-step translation, back-translation, and cross-cultural adaptation. The reliability and validity of the Chinese version of the CAF-R (CAF-R-CN) were tested among 448 patients with COPD (mean age =71.42± 9.33 years, 17.2% female) from four medical institutions in Suzhou, Jiangsu Province, using convenience sampling, from April 2022 to June 2023. Results: The CAF-R-CN included six dimensions with a total of 25 items. The item-level content validity index was 0.860– 1.000; the scale-level content validity index was 0.920. The structural validity χ2/df was 2.326, the root mean square error of approximation was 0.077, the comparative fit index was 0.924, and the Tucker–Lewis index was 0.912. The six-dimensional internal consistency index Cronbach’s α coefficient was 0.696– 0.910, and the test–retest reliability was 0.949. An optimal cut-off score of 50.5 was selected with a sensitivity of 0.786 and specificity of 0.870. Conclusion: The CAF-R-CN had satisfactory reliability and validity and can be used to identify and assess anxiety in COPD patients with a Chinese cultural background.
Keywords: fear, scale, specificity, chronic respiratory disease, Chinese translation, assessment
{"title":"Reliability, Validity, Modification and Expansion of the Chinese Version of the Disease-Specific Anxiety Questionnaire for Chronic Obstructive Pulmonary Disease","authors":"XiaoLang Miao, Yanxia Han, Zhenyun Wu, Xiaoliang Jin, Mei'e Niu, Qian Zhao, Xiangmin Lu","doi":"10.2147/copd.s455171","DOIUrl":"https://doi.org/10.2147/copd.s455171","url":null,"abstract":"<strong>Purpose:</strong> To translate a disease-specific anxiety questionnaire on chronic obstructive pulmonary disease (COPD) and test its reliability and validity in China.<br/><strong>Patients and Methods:</strong> The German version of the revised COPD Anxiety Questionnaire (CAF-R) was initially validated using step-by-step translation, back-translation, and cross-cultural adaptation. The reliability and validity of the Chinese version of the CAF-R (CAF-R-CN) were tested among 448 patients with COPD (mean age =71.42± 9.33 years, 17.2% female) from four medical institutions in Suzhou, Jiangsu Province, using convenience sampling, from April 2022 to June 2023.<br/><strong>Results:</strong> The CAF-R-CN included six dimensions with a total of 25 items. The item-level content validity index was 0.860– 1.000; the scale-level content validity index was 0.920. The structural validity χ<sup>2</sup>/df was 2.326, the root mean square error of approximation was 0.077, the comparative fit index was 0.924, and the Tucker–Lewis index was 0.912. The six-dimensional internal consistency index Cronbach’s α coefficient was 0.696– 0.910, and the test–retest reliability was 0.949. An optimal cut-off score of 50.5 was selected with a sensitivity of 0.786 and specificity of 0.870.<br/><strong>Conclusion:</strong> The CAF-R-CN had satisfactory reliability and validity and can be used to identify and assess anxiety in COPD patients with a Chinese cultural background.<br/><br/><strong>Keywords:</strong> fear, scale, specificity, chronic respiratory disease, Chinese translation, assessment<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melissa H Roberts, David M Mannino, Douglas W Mapel, Orsolya Lunacsek, Shahla Amin, Eileen Farrelly, Norbert Feigler, Michael F Pollack
Purpose: Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with reduced life expectancy, increased morbidity, mortality, and cost. This study characterized the US COPD burden, including socioeconomic and health-related quality of life (HRQoL) outcomes. Study Design and Methods: In this retrospective, cross-sectional study using nationally representative estimates from Medical Expenditures Survey (MEPS) data (2016– 2019), adults (≥ 18 years) living with and without COPD were identified. Adults living without COPD (control cohort) and with COPD were matched 5:1 on age, sex, geographic region, and entry year. Demographics, clinical characteristics, socioeconomic, and generic HRQoL measures were examined to include a race-stratified analysis of people living with COPD. Results: A total of 4,135 people living with COPD were identified; the matched dataset represented a weighted non-institutionalized population of 11.3 million with and 54.2 million people without COPD. Among people living with COPD, 66.3% had ≥ 1 COPD-related condition; 62.7% had ≥ 1 cardiovascular condition, compared to 33.5% and 50.5% without COPD. More people living with COPD were unemployed (56.2% vs 45.3%), unable to work due to illness/disability (30.1% vs 12.1%), had problems paying bills (16.1% vs 8.8%), reported poorer perceived health (fair/poor: 36.2% vs 14.4%), missed more working days due to illness/injury per year (median, 2.5 days vs 0.0 days), and had limitations in physical functioning (40.1% vs 19.4%) (all P< 0.0001). In race-stratified analyses for people living with COPD, people self-reporting as Black had higher prevalence of cardiovascular-risk conditions, poorer socioeconomic and HRQoL outcomes, and higher healthcare expenses than White or Other races. Conclusion: Adults living with COPD had higher clinical disease burden, lower socioeconomic status, and reduced HRQoL than those without, with greater disparities among Black people living with COPD compared to White and other races. Understanding the characteristics of patients helps address care disparities and access challenges.
Keywords: COPD, burden of illness, healthcare cost, race/ethnicity
{"title":"Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US – Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019","authors":"Melissa H Roberts, David M Mannino, Douglas W Mapel, Orsolya Lunacsek, Shahla Amin, Eileen Farrelly, Norbert Feigler, Michael F Pollack","doi":"10.2147/copd.s446696","DOIUrl":"https://doi.org/10.2147/copd.s446696","url":null,"abstract":"<strong>Purpose:</strong> Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with reduced life expectancy, increased morbidity, mortality, and cost. This study characterized the US COPD burden, including socioeconomic and health-related quality of life (HRQoL) outcomes.<br/><strong>Study Design and Methods:</strong> In this retrospective, cross-sectional study using nationally representative estimates from Medical Expenditures Survey (MEPS) data (2016– 2019), adults (≥ 18 years) living with and without COPD were identified. Adults living without COPD (control cohort) and with COPD were matched 5:1 on age, sex, geographic region, and entry year. Demographics, clinical characteristics, socioeconomic, and generic HRQoL measures were examined to include a race-stratified analysis of people living with COPD.<br/><strong>Results:</strong> A total of 4,135 people living with COPD were identified; the matched dataset represented a weighted non-institutionalized population of 11.3 million with and 54.2 million people without COPD. Among people living with COPD, 66.3% had ≥ 1 COPD-related condition; 62.7% had ≥ 1 cardiovascular condition, compared to 33.5% and 50.5% without COPD. More people living with COPD were unemployed (56.2% vs 45.3%), unable to work due to illness/disability (30.1% vs 12.1%), had problems paying bills (16.1% vs 8.8%), reported poorer perceived health (fair/poor: 36.2% vs 14.4%), missed more working days due to illness/injury per year (median, 2.5 days vs 0.0 days), and had limitations in physical functioning (40.1% vs 19.4%) (all <em>P</em>< 0.0001). In race-stratified analyses for people living with COPD, people self-reporting as Black had higher prevalence of cardiovascular-risk conditions, poorer socioeconomic and HRQoL outcomes, and higher healthcare expenses than White or Other races.<br/><strong>Conclusion:</strong> Adults living with COPD had higher clinical disease burden, lower socioeconomic status, and reduced HRQoL than those without, with greater disparities among Black people living with COPD compared to White and other races. Understanding the characteristics of patients helps address care disparities and access challenges.<br/><br/><strong>Keywords:</strong> COPD, burden of illness, healthcare cost, race/ethnicity<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To present the preliminarily findings regarding the effects of a herbal medicine, Ninjin’yoeito, on comorbid frailty and sarcopenia in patients with chronic obstructive pulmonary disease (COPD). Patients and Methods: Patients with COPD (GOLD II or higher) and fatigue were randomly assigned to Group A (n = 28; no medication for 12 weeks, followed by 12-week administration) or B (n= 25; 24-week continuous administration). Visual analog scale (VAS) symptoms of fatigue, the COPD assessment test (CAT), and the modified Medical Research Council (mMRC) Dyspnea Scale were examined. Physical indices such asknee extension leg strength and walking speed, skeletal muscle mass index (SMI), and respiratory function test were also measured. Results: VAS fatigue scales in Group B significantly improved after 4, 8, and 12 weeks compared to those in Group A (each p< 0.001, respectively). Right and left knee extension leg strength in Group B significantly improved after 12 weeks compared to that in Group A (p=0.042 and p=0.037, respectively). The 1-s walking speed for continued to increase significantly over 24 weeks in Group B (p=0.016, p< 0.001, p< 0.001, p=0.004, p< 0.001, and p< 0.001 after 4, 8, 12, 16, 20, and 24 weeks, respectively); it also significantly increased after the administration of Ninjin’yoeito in Group A. In Group B, the SMI significantly increased at 12 weeks in patients with sarcopenia (p=0.025). The CAT scores in Group B significantly improved after 12 weeks compared to those in Group A (p=0.006). The mMRC scores in Group B also significantly improved after 8 and 12 weeks compared to those in Group A (p= 0.045 and p < 0.001, respectively). The changes in %FEV1.0 in Group B were significantly improved at 12 and 24 weeks (p=0.039 and p=0.036, respectively). Conclusion: Overall, Ninjin’yoeito significantly improved patients’ quality of life, physical activity, muscle mass, and possibly lung function, suggesting that Ninjin’yoeito may improve frailty and sarcopenia in patients with COPD.
目的：介绍一种名为 "Ninjin'yoeito "的草药对慢性阻塞性肺病（COPD）患者合并虚弱和肌肉疏松症的初步研究结果：将患有慢性阻塞性肺病（GOLD II 或更高）和疲劳的患者随机分配到 A 组（n = 28；12 周内不服药，然后服药 12 周）或 B 组（n = 25；连续服药 24 周）。对疲劳的视觉模拟量表（VAS）症状、慢性阻塞性肺病评估测试（CAT）和改良医学研究委员会（mMRC）呼吸困难量表进行了检查。此外，还测量了身体指标，如伸腿力量和行走速度、骨骼肌质量指数（SMI）和呼吸功能测试：结果：与 A 组相比，B 组的 VAS 疲劳量表在 4 周、8 周和 12 周后均有明显改善（P< 0.001）。与 A 组相比，B 组的左右膝关节伸展腿部力量在 12 周后有明显改善（p=0.042 和 p=0.037）。B 组患者的 1 秒步行速度在 24 周内持续显著增加（4、8、12、16、20 和 24 周后分别为 p=0.016、p< 0.001、p< 0.001、p=0.004、p< 0.001 和 p< 0.001）；A 组患者服用万年青后也显著增加。与 A 组相比，B 组的 CAT 评分在 12 周后明显改善（p=0.006）。与 A 组相比，B 组的 mMRC 评分在 8 周和 12 周后也有明显改善（分别为 p= 0.045 和 p < 0.001）。B组的FEV1.0%在12周和24周后也有明显改善（分别为p=0.039和p=0.036）：总体而言，宁津养乐多能明显改善患者的生活质量、体力活动、肌肉质量，并可能改善肺功能，这表明宁津养乐多可改善慢性阻塞性肺病患者的虚弱和肌肉疏松症。关键词：临床研究；虚弱；宁津养乐多；肌肉疏松症；疗效
{"title":"Effects of Ninjin’yoeito on Patients with Chronic Obstructive Pulmonary Disease and Comorbid Frailty and Sarcopenia: A Preliminary Open-Label Randomized Controlled Trial","authors":"Hiroyuki Ohbayashi, Mitsue Ariga, Kunihiro Ohta, Sahori Kudo, Osamu Furuta, Akinori Yamamoto","doi":"10.2147/copd.s441767","DOIUrl":"https://doi.org/10.2147/copd.s441767","url":null,"abstract":"<strong>Purpose:</strong> To present the preliminarily findings regarding the effects of a herbal medicine, Ninjin’yoeito, on comorbid frailty and sarcopenia in patients with chronic obstructive pulmonary disease (COPD).<br/><strong>Patients and Methods:</strong> Patients with COPD (GOLD II or higher) and fatigue were randomly assigned to Group A (n = 28; no medication for 12 weeks, followed by 12-week administration) or B (n= 25; 24-week continuous administration). Visual analog scale (VAS) symptoms of fatigue, the COPD assessment test (CAT), and the modified Medical Research Council (mMRC) Dyspnea Scale were examined. Physical indices such asknee extension leg strength and walking speed, skeletal muscle mass index (SMI), and respiratory function test were also measured.<br/><strong>Results:</strong> VAS fatigue scales in Group B significantly improved after 4, 8, and 12 weeks compared to those in Group A (each p< 0.001, respectively). Right and left knee extension leg strength in Group B significantly improved after 12 weeks compared to that in Group A (p=0.042 and p=0.037, respectively). The 1-s walking speed for continued to increase significantly over 24 weeks in Group B (p=0.016, p< 0.001, p< 0.001, p=0.004, p< 0.001, and p< 0.001 after 4, 8, 12, 16, 20, and 24 weeks, respectively); it also significantly increased after the administration of Ninjin’yoeito in Group A. In Group B, the SMI significantly increased at 12 weeks in patients with sarcopenia (p=0.025). The CAT scores in Group B significantly improved after 12 weeks compared to those in Group A (p=0.006). The mMRC scores in Group B also significantly improved after 8 and 12 weeks compared to those in Group A (p= 0.045 and p < 0.001, respectively). The changes in %FEV1.0 in Group B were significantly improved at 12 and 24 weeks (p=0.039 and p=0.036, respectively).<br/><strong>Conclusion:</strong> Overall, Ninjin’yoeito significantly improved patients’ quality of life, physical activity, muscle mass, and possibly lung function, suggesting that Ninjin’yoeito may improve frailty and sarcopenia in patients with COPD.<br/><br/><strong>Keywords:</strong> clinical study, frailty, Ninjin’yoeito, sarcopenia, therapeutic effect<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The prevalence of airflow obstruction in Japan is 3.8%– 16.9%. This epidemiological study based on a large database aimed to reassess the prevalence of airflow obstruction in Japan and the diagnosis rate of chronic obstructive pulmonary disease (COPD). Patients and Methods: We used data regarding claims from the health insurance union and health checkups provided by JMDC. The present study included a subgroup of individuals aged ≥ 40 years who underwent health checkups involving spirometry between January and December 2019. The study endpoints were the prevalence of airflow obstruction, COPD diagnosis rate, disease stage, and respiratory function test results. Results: Among 102,190 participants, 4113 (4.0%) had airflow obstruction. The prevalence of airflow obstruction was 5.3% in men and 2.1% in women. Among the study population, 6.8% were current smokers, while 3.4% were never or former smokers. Additionally, the prevalence of COPD increased with age. Approximately 8.4% of participants with airflow obstruction were diagnosed with COPD. Regarding the COPD diagnosis status, participants with airflow obstruction who were diagnosed with COPD were at a more advanced stage than those not diagnosed. Finally, patients diagnosed with COPD had significantly lower FEV1/FVC and FEV1 (p < 0.0001; Wilcoxon rank sum test). Conclusion: The epidemiological study based on a large database determined the COPD diagnosis rate related to airflow obstruction. The COPD diagnosis rate was extremely low among individuals who underwent health checkups, indicating the need for increased awareness about this medical condition. Moreover, primary care physicians should identify patients with suspected COPD and collaborate with pulmonologists to facilitate the early detection of COPD and enhance the COPD diagnosis rate.
Keywords: COPD, epidemiology, airflow obstruction, prevalence, Japan, real-world data
{"title":"Underdiagnosis of COPD: The Japan COPD Real-World Data Epidemiological (CORE) Study","authors":"Yuka Koga, Sayaka Deguchi, Takeshi Matsuo, Akinori Suzuki, Gen Terashima, Takumi Tajima, Yoko Shibata, Hironori Sagara","doi":"10.2147/copd.s450270","DOIUrl":"https://doi.org/10.2147/copd.s450270","url":null,"abstract":"<strong>Purpose:</strong> The prevalence of airflow obstruction in Japan is 3.8%– 16.9%. This epidemiological study based on a large database aimed to reassess the prevalence of airflow obstruction in Japan and the diagnosis rate of chronic obstructive pulmonary disease (COPD).<br/><strong>Patients and Methods:</strong> We used data regarding claims from the health insurance union and health checkups provided by JMDC. The present study included a subgroup of individuals aged ≥ 40 years who underwent health checkups involving spirometry between January and December 2019. The study endpoints were the prevalence of airflow obstruction, COPD diagnosis rate, disease stage, and respiratory function test results.<br/><strong>Results:</strong> Among 102,190 participants, 4113 (4.0%) had airflow obstruction. The prevalence of airflow obstruction was 5.3% in men and 2.1% in women. Among the study population, 6.8% were current smokers, while 3.4% were never or former smokers. Additionally, the prevalence of COPD increased with age. Approximately 8.4% of participants with airflow obstruction were diagnosed with COPD. Regarding the COPD diagnosis status, participants with airflow obstruction who were diagnosed with COPD were at a more advanced stage than those not diagnosed. Finally, patients diagnosed with COPD had significantly lower FEV<sub>1</sub>/FVC and FEV<sub>1</sub> (p < 0.0001; Wilcoxon rank sum test).<br/><strong>Conclusion:</strong> The epidemiological study based on a large database determined the COPD diagnosis rate related to airflow obstruction. The COPD diagnosis rate was extremely low among individuals who underwent health checkups, indicating the need for increased awareness about this medical condition. Moreover, primary care physicians should identify patients with suspected COPD and collaborate with pulmonologists to facilitate the early detection of COPD and enhance the COPD diagnosis rate.<br/><br/><strong>Keywords:</strong> COPD, epidemiology, airflow obstruction, prevalence, Japan, real-world data<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Investigate the efficacy of blood microRNAs (miRNAs) as diagnostic biomarkers for Chronic Obstructive Pulmonary Disease (COPD). Patients and Methods: We conducted a comprehensive search in English and Chinese databases, selecting studies based on predetermined criteria. Diagnostic parameters like summarized sensitivity (SSEN), summarized specificity (SSPE), summarized positive likelihood ratio (SPLR), summarized negative likelihood ratio (SNLR), and diagnostic odds ratio (DOR), and area under the curve (AUC) of the summary receiver operating characteristic (SROC) curves were analyzed using a bivariate model. Each parameter was accompanied by a 95% confidence interval (CI). Results: Eighteen high-quality studies were included. For diagnosing COPD with blood miRNAs, the SSEN was 0.83 (95% CI 0.76– 0.89), SSPE 0.76 (95% CI 0.70– 0.82), SPLR 3.50 (95% CI 2.66– 4.60), SNLR 0.22 (95% CI 0.15– 0.33), DOR 15.72 (95% CI 8.58– 28.77), and AUC 0.86 (95% CI 0.82– 0.88). In acute exacerbations, SSEN was 0.85 (95% CI 0.76– 0.91), SSPE 0.80 (95% CI 0.73– 0.86), SPLR 4.26 (95% CI 3.05– 5.95), SNLR 0.19 (95% CI 0.12– 0.30), DOR 22.29 (95% CI 11.47– 43.33), and AUC 0.89 (95% CI 0.86– 0.91). Conclusion: Blood miRNAs demonstrate significant accuracy in diagnosing COPD, both in general and during acute exacerbations, suggesting their potential as reliable biomarkers.
目的：研究血液微RNA（miRNA）作为慢性阻塞性肺病（COPD）诊断生物标志物的有效性：我们在中英文数据库中进行了全面检索，根据预先确定的标准筛选研究。使用双变量模型分析了诊断参数，如概括灵敏度（SSEN）、概括特异度（SSPE）、概括阳性似然比（SPLR）、概括阴性似然比（SNLR）和诊断几率比（DOR），以及概括接收者操作特征曲线（SROC）的曲线下面积（AUC）。每个参数都附有 95% 的置信区间 (CI)：结果：共纳入了 18 项高质量的研究。用血液 miRNA 诊断慢性阻塞性肺病的 SSEN 为 0.83（95% CI 0.76-0.89），SSPE 为 0.76（95% CI 0.70-0.82），SPLR 为 3.50（95% CI 2.66-4.60），SNLR 为 0.22（95% CI 0.15-0.33），DOR 为 15.72（95% CI 8.58-28.77），AUC 为 0.86（95% CI 0.82-0.88）。在急性加重期，SSEN 为 0.85 (95% CI 0.76- 0.91)，SSPE 为 0.80 (95% CI 0.73- 0.86)，SPLR 为 4.26 (95% CI 3.05- 5.95)，SNLR 为 0.19 (95% CI 0.12- 0.30)，DOR 为 22.29 (95% CI 11.47- 43.33)，AUC 为 0.89 (95% CI 0.86- 0.91)：血液miRNAs在诊断慢性阻塞性肺疾病（包括一般情况和急性加重期）时表现出明显的准确性，表明它们具有作为可靠生物标志物的潜力。 关键词：miRNAs；慢性阻塞性肺疾病；生物标志物；荟萃分析；诊断
{"title":"Blood miRNAs as Potential Diagnostic Biomarkers for Chronic Obstructive Pulmonary Disease: A Meta-Analysis","authors":"Xiaohua Li, Guoxia Fu, Chunrong Zhang, Yu Wu, Hua Guo, Weiming Li, Xuefeng Zeng","doi":"10.2147/copd.s457172","DOIUrl":"https://doi.org/10.2147/copd.s457172","url":null,"abstract":"<strong>Purpose:</strong> Investigate the efficacy of blood microRNAs (miRNAs) as diagnostic biomarkers for Chronic Obstructive Pulmonary Disease (COPD).<br/><strong>Patients and Methods:</strong> We conducted a comprehensive search in English and Chinese databases, selecting studies based on predetermined criteria. Diagnostic parameters like summarized sensitivity (SSEN), summarized specificity (SSPE), summarized positive likelihood ratio (SPLR), summarized negative likelihood ratio (SNLR), and diagnostic odds ratio (DOR), and area under the curve (AUC) of the summary receiver operating characteristic (SROC) curves were analyzed using a bivariate model. Each parameter was accompanied by a 95% confidence interval (CI).<br/><strong>Results:</strong> Eighteen high-quality studies were included. For diagnosing COPD with blood miRNAs, the SSEN was 0.83 (95% CI 0.76– 0.89), SSPE 0.76 (95% CI 0.70– 0.82), SPLR 3.50 (95% CI 2.66– 4.60), SNLR 0.22 (95% CI 0.15– 0.33), DOR 15.72 (95% CI 8.58– 28.77), and AUC 0.86 (95% CI 0.82– 0.88). In acute exacerbations, SSEN was 0.85 (95% CI 0.76– 0.91), SSPE 0.80 (95% CI 0.73– 0.86), SPLR 4.26 (95% CI 3.05– 5.95), SNLR 0.19 (95% CI 0.12– 0.30), DOR 22.29 (95% CI 11.47– 43.33), and AUC 0.89 (95% CI 0.86– 0.91).<br/><strong>Conclusion:</strong> Blood miRNAs demonstrate significant accuracy in diagnosing COPD, both in general and during acute exacerbations, suggesting their potential as reliable biomarkers.<br/><br/><strong>Keywords:</strong> miRNAs, chronic obstructive pulmonary disease, biomarker, meta-analysis, diagnosis<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sean Richard Davidson, Muhammed Y Idris, Christopher S Awad, Marshaleen Henriques King, Gloria E Westney, Mario Ponce, Anny D Rodriguez, Kim L Lipsey, Eric L Flenaugh, Marilyn G Foreman
Aim: Increasing evidence suggests that the inclusion of self-identified race in clinical decision algorithms may perpetuate longstanding inequities. Until recently, most pulmonary function tests utilized separate reference equations that are race/ethnicity based. Purpose: We assess the magnitude and scope of the available literature on the negative impact of race-based pulmonary function prediction equations on relevant outcomes in African Americans with COPD. Methods: We performed a scoping review utilizing an English language search on PubMed/Medline, Embase, Scopus, and Web of Science in September 2022 and updated it in December 2023. We searched for publications regarding the effect of race-specific vs race-neutral, race-free, or race-reversed lung function testing algorithms on the diagnosis of COPD and COPD-related physiologic and functional measures. Joanna Briggs Institute (JBI) guidelines were utilized for this scoping review. Eligibility criteria: The search was restricted to adults with COPD. We excluded publications on other lung disorders, non-English language publications, or studies that did not include African Americans. The search identified publications. Ultimately, six peer-reviewed publications and four conference abstracts were selected for this review. Results: Removal of race from lung function prediction equations often had opposite effects in African Americans and Whites, specifically regarding the severity of lung function impairment. Symptoms and objective findings were better aligned when race-specific reference values were not used. Race-neutral prediction algorithms uniformly resulted in reclassifying severity in the African Americans studied. Conclusion: The limited literature does not support the use of race-based lung function prediction equations. However, this assertion does not provide guidance for every specific clinical situation. For African Americans with COPD, the use of race-based prediction equations appears to fall short in enhancing diagnostic accuracy, classifying severity of impairment, or predicting subsequent clinical events. We do not have information comparing race-neutral vs race-based algorithms on prediction of progression of COPD. We conclude that the elimination of race-based reference values potentially reduces underestimation of disease severity in African Americans with COPD.
Keywords: lung function tests, lung function prediction equations, African Americans
目的：越来越多的证据表明，在临床决策算法中纳入自我认定的种族可能会使长期存在的不公平现象永久化。目的：我们评估了现有文献中基于种族的肺功能预测方程对患有慢性阻塞性肺病的非裔美国人相关结果的负面影响的程度和范围：我们于 2022 年 9 月利用英文在 PubMed/Medline、Embase、Scopus 和 Web of Science 上进行了一次范围审查，并于 2023 年 12 月进行了更新。我们检索了有关种族特异性与种族中立性、无种族或种族逆转肺功能测试算法对慢性阻塞性肺疾病诊断以及慢性阻塞性肺疾病相关生理和功能指标影响的出版物。乔安娜-布里格斯研究所（Joanna Briggs Institute，JBI）指南被用于此次范围界定审查。资格标准：检索仅限于患有慢性阻塞性肺病的成年人。我们排除了有关其他肺部疾病的出版物、非英语出版物或不包括非裔美国人的研究。搜索确定了出版物。最终，本综述选取了六篇经同行评审的出版物和四篇会议摘要：结果：将种族从肺功能预测方程中剔除，往往会对非裔美国人和白人产生相反的影响，特别是在肺功能受损的严重程度方面。如果不使用特定种族的参考值，症状和客观结果会更加一致。在所研究的非裔美国人中，种族中立的预测算法一致导致了严重程度的重新分类：有限的文献资料不支持使用基于种族的肺功能预测方程。结论：有限的文献资料并不支持使用基于种族的肺功能预测方程，但这一论断并不能为每一种特定的临床情况提供指导。对于患有慢性阻塞性肺病的非裔美国人来说，使用基于种族的预测方程似乎无法提高诊断的准确性、对损伤的严重程度进行分类或预测后续的临床事件。在预测慢性阻塞性肺病的进展方面，我们没有比较种族中立算法和基于种族算法的信息。我们的结论是，取消基于种族的参考值可能会减少对患有慢性阻塞性肺病的非裔美国人疾病严重程度的低估。关键词：肺功能测试；肺功能预测方程；非裔美国人
{"title":"Race Adjustment of Pulmonary Function Tests in the Diagnosis and Management of COPD: A Scoping Review","authors":"Sean Richard Davidson, Muhammed Y Idris, Christopher S Awad, Marshaleen Henriques King, Gloria E Westney, Mario Ponce, Anny D Rodriguez, Kim L Lipsey, Eric L Flenaugh, Marilyn G Foreman","doi":"10.2147/copd.s430249","DOIUrl":"https://doi.org/10.2147/copd.s430249","url":null,"abstract":"<strong>Aim:</strong> Increasing evidence suggests that the inclusion of self-identified race in clinical decision algorithms may perpetuate longstanding inequities. Until recently, most pulmonary function tests utilized separate reference equations that are race/ethnicity based.<br/><strong>Purpose:</strong> We assess the magnitude and scope of the available literature on the negative impact of race-based pulmonary function prediction equations on relevant outcomes in African Americans with COPD.<br/><strong>Methods:</strong> We performed a scoping review utilizing an English language search on PubMed/Medline, Embase, Scopus, and Web of Science in September 2022 and updated it in December 2023. We searched for publications regarding the effect of race-specific vs race-neutral, race-free, or race-reversed lung function testing algorithms on the diagnosis of COPD and COPD-related physiologic and functional measures. Joanna Briggs Institute (JBI) guidelines were utilized for this scoping review. Eligibility criteria: The search was restricted to adults with COPD. We excluded publications on other lung disorders, non-English language publications, or studies that did not include African Americans. The search identified publications. Ultimately, six peer-reviewed publications and four conference abstracts were selected for this review.<br/><strong>Results:</strong> Removal of race from lung function prediction equations often had opposite effects in African Americans and Whites, specifically regarding the severity of lung function impairment. Symptoms and objective findings were better aligned when race-specific reference values were not used. Race-neutral prediction algorithms uniformly resulted in reclassifying severity in the African Americans studied.<br/><strong>Conclusion:</strong> The limited literature does not support the use of race-based lung function prediction equations. However, this assertion does not provide guidance for every specific clinical situation. For African Americans with COPD, the use of race-based prediction equations appears to fall short in enhancing diagnostic accuracy, classifying severity of impairment, or predicting subsequent clinical events. We do not have information comparing race-neutral vs race-based algorithms on prediction of progression of COPD. We conclude that the elimination of race-based reference values potentially reduces underestimation of disease severity in African Americans with COPD.<br/><br/><strong>Keywords:</strong> lung function tests, lung function prediction equations, African Americans<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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