Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, Spain; Grupo C039 Biodiscovery HULA-USC, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain.
Rev Clin Esp (Barc). 2021 Nov;221(9):536-539. doi: 10.1016/j.rceng.2021.01.009. Epub 2021 Sep 11.
Pharmacological treatment of chronic obstructive pulmonary disease in Spain is usually chosen according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) or Spanish guidelines for chronic obstructive pulmonary disease (GesEPOC). The main objective of this study was to evaluate the degree of concordance between treatment for newly diagnosed chronic obstructive pulmonary disease patients according to GOLD and GesEPOC.
Simulation study. The following variables were used: FEV%, exacerbations, dyspnoea at first evaluation, blood eosinophilia, personal history of asthma, and degree of bronchodilator reversibility. Four investigators classified and assigned a treatment to each patient (2 using GOLD criteria and the other 2 using GesEPOC). Global Kappa index was calculated.
The database included 467 patients. Agreement between treatment decided using GOLD and GesEPOC was poor (Kappa: 0.17, 95% CI: 0.12-0.23).
There is a poor agreement between GOLD and GesEPOC recommendations for initial chronic obstructive pulmonary disease treatment.
在西班牙，慢性阻塞性肺疾病的药物治疗通常根据全球慢性阻塞性肺疾病倡议（GOLD）或西班牙慢性阻塞性肺疾病指南（GesEPOC）来选择。本研究的主要目的是评估根据 GOLD 和 GesEPOC 诊断的新确诊慢性阻塞性肺疾病患者的治疗方案的一致性程度。
模拟研究。使用以下变量：FEV%、加重次数、首次评估时的呼吸困难程度、血嗜酸性粒细胞计数、个人哮喘史和支气管扩张剂可逆性程度。四位研究者对每位患者进行分类并分配治疗方案（其中 2 位使用 GOLD 标准，另外 2 位使用 GesEPOC）。计算总体 Kappa 指数。
数据库包括 467 名患者。使用 GOLD 和 GesEPOC 决定的治疗方案之间的一致性较差（Kappa：0.17，95%CI：0.12-0.23）。
GOLD 和 GesEPOC 对初始慢性阻塞性肺疾病治疗的建议之间存在较差的一致性。
