Moya-Álvarez Virginia, Quevedo-Marín Juan Luis, Ji Zichen, Navarro-Jiménez Cristina, Jiménez-García Rodrigo, López-de-Andrés Ana, Pérez-Trullén Alfonso, de Miguel-Díez Javier
Faculty of Medicine, Francisco de Vitoria University, Madrid 28223, Spain.
Rey Juan Carlos University, Madrid 28922, Spain.
Int J Chron Obstruct Pulmon Dis. 2020 Aug 12;15:1987-1995. doi: 10.2147/COPD.S253445. eCollection 2020.
The Global Organization of Lung Disease (GOLD) classifies patients with chronic obstructive pulmonary disease (COPD) taking into account the symptoms. The modified Medical Research Council's dyspnea scale (mMRC) and the COPD assessment test (CAT) are used to assess these symptoms. In this study, we analyze the concordance of GOLD classification using mMRC and CAT.
This is an observational study of a cohort of 169 patients with COPD, who were classified following the GOLD 2017 recommendations, using both mMRC and CAT. A concordance analysis was applied, and a ROC curve was generated to identify the CAT score that best concorded with the mMRC scale.
The concordance for the GOLD groups classified by CAT and mMRC was moderate ( 0.492). For mMRC score of 1 and 2, a CAT score of ≥9 and ≥16 showed the maximum value of the Youden index, respectively. By reclassifying the patients with the new cut-off points obtained, the best concordance was obtained between the cut-off point for CAT of 16 and for mMRC of 2, followed by CAT of 9 and mMRC of 1.
Because of the deficient concordance between CAT and mMRC, we propose the use of new cut-off points in future updates of the GOLD strategy.
全球肺部疾病组织（GOLD）根据症状对慢性阻塞性肺疾病（COPD）患者进行分类。改良的医学研究委员会呼吸困难量表（mMRC）和慢性阻塞性肺疾病评估测试（CAT）用于评估这些症状。在本研究中，我们分析了使用mMRC和CAT进行GOLD分类的一致性。
这是一项对169例COPD患者队列的观察性研究，这些患者按照GOLD 2017推荐标准，使用mMRC和CAT进行分类。应用一致性分析，并生成ROC曲线以确定与mMRC量表最一致的CAT评分。
CAT和mMRC对GOLD组的分类一致性为中等（0.492）。对于mMRC评分为1和2的情况，CAT评分≥9和≥16分别显示约登指数的最大值。通过使用获得的新切点对患者重新分类，在CAT为16和mMRC为2的切点之间获得了最佳一致性，其次是CAT为9和mMRC为1。
由于CAT和mMRC之间的一致性不足，我们建议在GOLD策略的未来更新中使用新的切点。
