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New GOLD classification: longitudinal data on group assignment Casanova C; Marin JM; Martinez-Gonzalez C; de Lucas-Ramos P; Mir-Viladrich I; Cosio B; Peces-Barba G; Calle-Rubio M; Solanes-Garcia I; Aguero R; de Diego-Damia A; Feu-Collado N; Alfageme I; Irigaray R; Balcells E; Llunell A; Galdiz JB; Marin M; Soler-Cataluna JJ; Lopez-Campos JL; Soriano JB; de-Torres JPRespir Res 2014[Jan]; 15 (1): 3RATIONALE: Little is known about the longitudinal changes associated with using the 2013 update of the multidimensional GOLD strategy for chronic obstructive pulmonary disease (COPD). OBJECTIVE: To determine the COPD patient distribution of the new GOLD proposal and evaluate how this classification changes over one year compared with the previous GOLD staging based on spirometry only. METHODS: We analyzed data from the CHAIN study, a multicenter observational Spanish cohort of COPD patients who are monitored annually. Categories were defined according to the proposed GOLD: FEV1%, mMRC dyspnea, COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and exacerbations-hospitalizations. One-year follow-up information was available for all variables except CCQ data. RESULTS: At baseline, 828 stable COPD patients were evaluated. On the basis of mMRC dyspnea versus CAT, the patients were distributed as follows: 38.2% vs. 27.2% in group A, 17.6% vs. 28.3% in group B, 15.8% vs. 12.9% in group C, and 28.4% vs. 31.6% in group D. Information was available for 526 patients at one year: 64.2% of patients remained in the same group but groups C and D show different degrees of variability. The annual progression by group was mainly associated with one-year changes in CAT scores (RR, 1.138; 95%CI: 1.074-1.206) and BODE index values (RR, 2.012; 95%CI: 1.487-2.722). CONCLUSIONS: In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index.|Aged[MESH]|Cohort Studies[MESH]|Databases, Factual/*classification/trends[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Global Health/*classification[MESH]|Humans[MESH]|Longitudinal Studies[MESH]|Male[MESH]|Middle Aged[MESH]|Prospective Studies[MESH]|Pulmonary Disease, Chronic Obstructive/*classification/*diagnosis/epidemiology[MESH]|Spain/epidemiology[MESH] |
