An individualized prediction model for long-term lung function trajectory and risk of COPD in the general population.

An individualized prediction model for long-term lung function trajectory and risk of COPD in the general population. Chest. 2019 Sep 19;: Authors: Chen W, Sin DD, FitzGerald JM, Safari A, Adibi A, Sadatsafavi M Abstract BACKGROUND: Prediction of future lung function will enable the identification of individuals at high risk of developing chronic obstructive pulmonary disease (COPD), but the trajectory of lung function decline greatly varies among individuals. We developed and validated an individualized prediction model of lung function trajectory and risk of airflow limitation in the general population. METHODS: Data were obtained from the Framingham Offspring Cohort, which included 4,167 participants ≥20 years of age and had ≥2 valid spirometry assessments. The primary outcome was pre-bronchodilator forced expiratory volume at 1 second (FEV1); the secondary outcome was the risk of airflow limitation (defined as FEV1/forced vital capacity
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research

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Current and former smokers with normal spirometry and with Preserved Ratio Impaired Spirometry (PRISm) experience respiratory events similar to chronic obstructive pulmonary disease (COPD) exacerbations. Exacerbations significantly reduce quality of life (QoL) in COPD patients however the effect of respiratory exacerbations on QoL in these groups is unknown. We hypothesized that exacerbations and change in exacerbation status would predict QoL decline among normal spirometry and PRISm participants in COPDGene.
Source: Respiratory Medicine - Category: Respiratory Medicine Authors: Source Type: research
ConclusionsPotentially inappropriate ICS use is common among patients with and without airflow obstruction who are diagnosed with COPD. We identified patient comorbidities and patterns of healthcare utilization that increase the likelihood of ICS use that could be targeted for system-level de-implementation interventions.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Discussion: Responses to the BLF COPD Patient Passport identify substantial gaps in patients' experience of care, which did not appear to improve during the 5 years covered. These data provide a unique yet commonly overlooked perspective on care quality, and highlight that new approaches will be needed to meet the ambitions to improve respiratory care set out in the NHS Long Term Plan. PMID: 31673369 [PubMed]
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: BMJ Open Respir Res Source Type: research
We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling. Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66% (95% CI 0.06%–1.27%) ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: COPD Source Type: research
COPD is a common disease that predominantly affects smokers and is characterised by persistent and usually progressive airflow limitation [1]. While international bodies, such as the Global Initiative for Chronic Obstructive Lung Disease (GOLD), have varied in their classification system for COPD severity over the years, there has long been recognition that pathologically [2] and clinically [3] relevant disease may be present before spirometry becomes abnormal. Indeed, GOLD included "at risk" as a disease stage in early iterations of their documents on COPD.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research
Conclusions: Importantly, lung function in both the groups was affected by decreased vitamin D level; decrease in FEV1 was more pronounced among COPD patients compared to controls showing more expiratory airflow limitation. Vitamin D levels are associated with changes in lung function in cases of COPD as well as healthy controls. Larger studies to confirm the association in Indian context are required and routine assessment of vitamin D may be undertaken to obviate the effects of low vitmain D level on lung function.
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
Conclusion: Hypoxia causes long-term decline in hearing thresholds, deterioration of DPOAE results, and prolongation of I–V interpeak latency in auditory brainstem response. However, the critical oxygen level that disrupts hearing function could not be determined. PMID: 31651111 [PubMed - in process]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
AbstractTo investigate the effects of photobiomodulation applied to respiratory muscles on lung function, thoracoabdominal mobility, respiratory muscle strength, and functional capacity in COPD patients. This is a randomized double-blind crossover clinical trial. Twelve male COPD patients participated in the study. Participants were randomly allocated to receive two photobiomodulation sessions, 1  week apart: (1) an effective photobiomodulation session applied at the main respiratory muscles by means of a cluster with 69 light-emitting diodes (LEDs), containing 35 red (630 ± 10 nm; 10 mW...
Source: Lasers in Medical Science - Category: Laser Surgery Source Type: research
In Reply We disagree with Drs Miller and Stanojevic that our results were mainly due to clinicians ’ use of the fixed ratio of 0.70 for the diagnosis of COPD. Clinicians were blinded to study spirometry, and spirometry is substantially underutilized in clinical care. Furthermore, in the context of substantial debate on optimal spirometric criteria, it is unknown which threshold may have been se lected by treating physicians. In a number of cases, it is possible that a clinical diagnosis of chronic bronchitis was made. A diagnostic threshold should have meaningful prognostic utility, and in the absence of a diagnostic...
Source: JAMA - Category: General Medicine Source Type: research
To the Editor A study examining the discriminatory accuracy of different thresholds of the ratio of forced expiratory volume in the first second to forced vital capacity (FEV1:FVC) to define chronic obstructive pulmonary disease (COPD) concluded that a fixed ratio of 0.7 best identified patients with COPD-related hospitalization or mortality. However, the conclusion from this work should be that the majority of clinicians caring for the patients in their study used the fixed ratio of 0.7 to diagnose COPD. The authors used International Classification of Diseases (ICD), Ninth Revision and Tenth Revision, codes for COPD as i...
Source: JAMA - Category: General Medicine Source Type: research
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