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A simple algorithm for the identification of clinical COPD phenotypes
European Respiratory Journal ( IF 24.3 ) Pub Date : 2017-11-01 , DOI: 10.1183/13993003.01034-2017
Pierre-Régis Burgel , Jean-Louis Paillasseur , Wim Janssens , Jacques Piquet , Gerben ter Riet , Judith Garcia-Aymerich , Borja Cosio , Per Bakke , Milo A. Puhan , Arnulf Langhammer , Inmaculada Alfageme , Pere Almagro , Julio Ancochea , Bartolome R. Celli , Ciro Casanova , Juan P. de-Torres , Marc Decramer , Andrés Echazarreta , Cristobal Esteban , Rosa Mar Gomez Punter , MeiLan K. Han , Ane Johannessen , Bernhard Kaiser , Bernd Lamprecht , Peter Lange , Linda Leivseth , Jose M. Marin , Francis Martin , Pablo Martinez-Camblor , Marc Miravitlles , Toru Oga , Ana Sofia Ramírez , Don D. Sin , Patricia Sobradillo , Juan J. Soler-Cataluña , Alice M. Turner , Francisco Javier Verdu Rivera , Joan B. Soriano , Nicolas Roche

This study aimed to identify simple rules for allocating chronic obstructive pulmonary disease (COPD) patients to clinical phenotypes identified by cluster analyses. Data from 2409 COPD patients of French/Belgian COPD cohorts were analysed using cluster analysis resulting in the identification of subgroups, for which clinical relevance was determined by comparing 3-year all-cause mortality. Classification and regression trees (CARTs) were used to develop an algorithm for allocating patients to these subgroups. This algorithm was tested in 3651 patients from the COPD Cohorts Collaborative International Assessment (3CIA) initiative. Cluster analysis identified five subgroups of COPD patients with different clinical characteristics (especially regarding severity of respiratory disease and the presence of cardiovascular comorbidities and diabetes). The CART-based algorithm indicated that the variables relevant for patient grouping differed markedly between patients with isolated respiratory disease (FEV1, dyspnoea grade) and those with multi-morbidity (dyspnoea grade, age, FEV1 and body mass index). Application of this algorithm to the 3CIA cohorts confirmed that it identified subgroups of patients with different clinical characteristics, mortality rates (median, from 4% to 27%) and age at death (median, from 68 to 76 years). A simple algorithm, integrating respiratory characteristics and comorbidities, allowed the identification of clinically relevant COPD phenotypes. An algorithm integrating respiratory characteristics and comorbidities identifies clinical COPD phenotypes http://ow.ly/eSRp30fJPG5

中文翻译:

用于识别临床 COPD 表型的简单算法

本研究旨在确定将慢性阻塞性肺疾病 (COPD) 患者分配到通过聚类分析确定的临床表型的简单规则。使用聚类分析对来自法国/比利时 COPD 队列的 2409 名 COPD 患者的数据进行了分析,从而确定了亚组,通过比较 3 年全因死亡率来确定亚组的临床相关性。分类和回归树 (CART) 用于开发将患者分配到这些亚组的算法。该算法在来自 COPD 队列协作国际评估 (3CIA) 计划的 3651 名患者中进行了测试。聚类分析确定了具有不同临床特征(尤其是呼吸系统疾病的严重程度以及心血管合并症和糖尿病的存在)的 COPD 患者的五个亚组。基于 CART 的算法表明,与患者分组相关的变量在孤立性呼吸道疾病患者(FEV1,呼吸困难分级)和多发病患者(呼吸困难分级、年龄、FEV1 和体重指数)之间存在显着差异。将该算法应用于 3CIA 队列证实,它确定了具有不同临床特征、死亡率(中位数,4% 至 27%)和死亡年龄(中位数,68 至 76 岁)的患者亚组。一个简单的算法,整合了呼吸特征和合并症,可以识别临床相关的 COPD 表型。一种整合呼吸特征和合并症的算法可识别临床 COPD 表型 http://ow.ly/eSRp30fJPG5 呼吸困难分级)和多发病(呼吸困难分级、年龄、FEV1 和体重指数)。将该算法应用于 3CIA 队列证实,它确定了具有不同临床特征、死亡率(中位数,4% 至 27%)和死亡年龄(中位数,68 至 76 岁)的患者亚组。一个简单的算法,整合了呼吸特征和合并症,可以识别临床相关的 COPD 表型。一种整合呼吸特征和合并症的算法可识别临床 COPD 表型 http://ow.ly/eSRp30fJPG5 呼吸困难分级)和多发病(呼吸困难分级、年龄、FEV1 和体重指数)。将该算法应用于 3CIA 队列证实,它确定了具有不同临床特征、死亡率(中位数,4% 至 27%)和死亡年龄(中位数,68 至 76 岁)的患者亚组。一个简单的算法,整合了呼吸特征和合并症,可以识别临床相关的 COPD 表型。一种整合呼吸特征和合并症的算法可识别临床 COPD 表型 http://ow.ly/eSRp30fJPG5 从 4% 到 27%)和死亡年龄(中位数,从 68 到 76 岁)。一个简单的算法,整合了呼吸特征和合并症,可以识别临床相关的 COPD 表型。一种整合呼吸特征和合并症的算法可识别临床 COPD 表型 http://ow.ly/eSRp30fJPG5 从 4% 到 27%)和死亡年龄(中位数,从 68 到 76 岁)。一个简单的算法,整合了呼吸特征和合并症,可以识别临床相关的 COPD 表型。一种整合呼吸特征和合并症的算法可识别临床 COPD 表型 http://ow.ly/eSRp30fJPG5
更新日期:2017-11-01
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