Assessing patient-reported outcomes in asthma and COPD patients

Kocks, Janwillem; Seys, Sven; Duin, Titia S van; Diamant, Zuzana; Tsiligianni, Ioanna

doi:10.1097/mcp.0000000000000447

Cited by 22 publications

(17 citation statements)

References 34 publications

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“…This review has provided insight into the quality and quantity of the MCID for various HRQoL and health status instruments in COPD, with CAT, CCQ, CRQ and SGRQ as the most important tools. The short CAT and CCQ are recommended especially for use in clinical practice; the lengthier CRQ and SGRQ are more applicable for scientific research [12,52,97].…”

Section: Summary Of Main Resultsmentioning

confidence: 99%

“…This study is the first to systematically address the MCIDs of COPD HRQoL and health status tools. Although other papers have provided an overview of instruments, none of them has addressed the methodology, values and triangulation of MCIDs [3,8,10,16,28,29,38,39,[46][47][48][49][50][51][52][53][54][55][56][57]. This study had a structurally defined protocol that was thoroughly executed by two independent reviewers.…”

Section: Strength and Limitations Of The Current Studymentioning

confidence: 99%

“…Given the importance of MCIDs for research and clinical practice, there has been an increase in studies investigating the MCID of HRQoL and health status tools in COPD. Various authors have provided overviews of frequently used instruments in COPD, incidentally reporting the value or a short description of its MCID [3,8,10,16,28,29,38,[46][47][48][49][50][51][52]. In addition, some publications have presented a description of the evidence for the MCID of specific COPD outcomes, including the St. George's Respiratory Questionnaire (SGRQ) [53], exacerbations [39], the transition dyspnoea index (TDI) [54], forced expiratory volume in 1 s (FEV1) [55], Clinical COPD Questionnaire (CCQ) [56] and COPD Assessment Test (CAT) [57].…”

Section: Introductionmentioning

confidence: 99%

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Clinically relevant differences in COPD health status: systematic review and triangulation

et al. 2018

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The minimal clinically important difference (MCID) quantifies when measured differences can be considered clinically relevant. This study aims to review and triangulate MCIDs of chronic obstructive pulmonary disease (COPD) health status tools.A systematic search in PubMed, EMBASE and Cochrane Library was conducted (Prospero #CRD42015023221). Study details, patient characteristics, MCID methodology and estimates were assessed and extracted by two authors. A triangulated mean was obtained for each tool's MCID, with two-thirds weighting for anchor-based and one-third for distribution-based results. This was then multiplied by a weighted factor based upon the study size and quality rating.Overall, 785 records were reviewed of which 21 studies were included for analysis. MCIDs of 12 tools were presented. General quality and risk of bias were average to good. Triangulated MCIDs for the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ) and St. George's Respiratory Questionnaire (SGRQ) were -2.54, -0.43 and -7.43 for improvement. Too few and/or too diverse studies were present to triangulate MCIDs of other tools.Evidence for the MCID of the CAT and CCQ was strong and triangulation was valid. Currently used MCIDs in clinical practice for the SGRQ (4) and Chronic Respiratory Questionnaire (0.5) did not match the reviewed content, for which the MCIDs were much higher. Using too low MCIDs may lead to an overestimation of the interpretation of treatment effects. MCIDs for deterioration were scarce, which highlights the need for more research.

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Section: Summary Of Main Resultsmentioning

confidence: 99%

Section: Strength and Limitations Of The Current Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinically relevant differences in COPD health status: systematic review and triangulation

et al. 2018

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“…Another strength is the inclusion of patient-reported outcome measures that are widely used and validated in COPD and asthma populations. 33 However, the SPRINT study also has some limitations. As an observational study, it is subject to confounders and potential bias.…”

Section: Discussionmentioning

confidence: 99%

Asthma control and COPD symptom burden in patients using fixed-dose combination inhalers (SPRINT study)

Roche

Plaza

Backer³

et al. 2020

npj Prim. Care Respir. Med.

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Previous studies have found suboptimal control of symptom burden to be widespread among patients with asthma and chronic obstructive pulmonary disease (COPD). The Phase IV SPRINT study was conducted in 10 countries in Europe to assess asthma disease control and COPD symptom burden in patients treated with a fixed-dose combination (FDC) of inhaled corticosteroids (ICS) and long-acting beta agonists (LABAs). SPRINT included 1101 patients with asthma and 560 with COPD; all were receiving treatment with an FDC of ICS/LABA, delivered via various inhalers. Data were obtained over a 3-month period, during a single routine physician’s office visit. Asthma control was defined as Asthma Control Test (ACT) score >19. COPD symptom burden was assessed by COPD Assessment Test (CAT), with a CAT score <10 defining low COPD symptom burden. Among patients using any ICS/LABA FDC, 62% of patients with asthma had achieved disease control (ACT score >19) and 16% of patients with COPD had low symptom burden (CAT score <10).

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“…Various studies have discussed the MCID of COPD health status tools [40], including the recommended questionnaires COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and the St. George's Respiratory Questionnaire (SGRQ) [2,41,42]. The MCIDs were determined as a rather fixed range of two to three points on the CAT [40,43e49], 0.40e0.50 on the CCQ [40,43,44,48e52], and four up to seven points on the SGRQ [40,43,44,53e57].…”

Section: Introductionmentioning

confidence: 99%

Baseline health status and setting impacted minimal clinically important differences in COPD: an exploratory study

Alma

Jong

Jelusic

et al. 2019

Journal of Clinical Epidemiology

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Objectives: Minimal clinically important differences (MCIDs) are used as fixed numbers in the interpretation of clinical trials. Little is known about its dynamics. This study aims to explore the impact of baseline score, study setting, and patient characteristics on health status MCIDs in chronic obstructive pulmonary disease (COPD). Study Design and Setting: Baseline and follow-up data on the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and St. George's Respiratory Questionnaire (SGRQ) were retrospectively analyzed from pulmonary rehabilitation (PR) and routine clinical practice (RCP). Anchor-and distribution-based MCID estimates were calculated and tested between settings, gender, age, Global initiative Funding: The main RIMTCORE trial (#DRKS00004609) was funded by the Deutsche Rentenversicherung, Germany. The Dutch observational study on COPD health status in routine clinical practice (MCID study) as well as the current combined retrospective analysis of both studies received financial support from the Junior Scientific Masterclass (JSM) as part of the

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Assessing patient-reported outcomes in asthma and COPD patients

Cited by 22 publications

References 34 publications

Clinically relevant differences in COPD health status: systematic review and triangulation

Clinically relevant differences in COPD health status: systematic review and triangulation

Asthma control and COPD symptom burden in patients using fixed-dose combination inhalers (SPRINT study)

Baseline health status and setting impacted minimal clinically important differences in COPD: an exploratory study

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