Prediction of lung emphysema in COPD by spirometry and clinical symptoms: results from COSYCONET
| العنوان: | Prediction of lung emphysema in COPD by spirometry and clinical symptoms: results from COSYCONET |
|---|---|
| المؤلفون: | Diego Kauffmann-Guerrero, Hans-Ulrich Kauczor, Alexander Hapfelmeier, Jürgen Biederer, Antonius Schneider, Rudolf A. Jörres, Johanna I. Lutter, Jürgen Behr, Claus Vogelmeier, Christina Kellerer, Helgo Magnussen, Peter Alter, Robert Bals, Franziska C. Trudzinski, Bertram J. Jobst, Henrik Watz, Tobias Welte, Kathrin Kahnert |
| المصدر: | Respiratory Research, Vol 22, Iss 1, Pp 1-11 (2021) Respir. Res. 22:242 (2021) Respiratory Research |
| بيانات النشر: | BMC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Spirometry, CT scan, medicine.medical_specialty, Decision trees, Adaboost, Comorbidity, Severity of Illness Index, Cohort Studies, Pulmonary Disease, Chronic Obstructive, Diseases of the respiratory system, Predictive Value of Tests, Internal medicine, Humans, Medicine, Lung emphysema, Prospective Studies, COPD phenotypes, Aged, Emphysema, COPD, medicine.diagnostic_test, RC705-779, business.industry, Research, Copd Phenotypes, Ct Scan, Decision Trees, Random Forest, Middle Aged, respiratory system, medicine.disease, respiratory tract diseases, Pulmonary Emphysema, Female, Tomography, X-Ray Computed, business, Random forest |
| الوصف: | Background Lung emphysema is an important phenotype of chronic obstructive pulmonary disease (COPD), and CT scanning is strongly recommended to establish the diagnosis. This study aimed to identify criteria by which physicians with limited technical resources can improve the diagnosis of emphysema. Methods We studied 436 COPD patients with prospective CT scans from the COSYCONET cohort. All items of the COPD Assessment Test (CAT) and the St George’s Respiratory Questionnaire (SGRQ), the modified Medical Research Council (mMRC) scale, as well as data from spirometry and CO diffusing capacity, were used to construct binary decision trees. The importance of parameters was checked by the Random Forest and AdaBoost machine learning algorithms. Results When relying on questionnaires only, items CAT 1 & 7 and SGRQ 8 & 12 sub-item 3 were most important for the emphysema- versus airway-dominated phenotype, and among the spirometric measures FEV1/FVC. The combination of CAT item 1 (≤ 2) with mMRC (> 1) and FEV1/FVC, could raise the odds for emphysema by factor 7.7. About 50% of patients showed combinations of values that did not markedly alter the likelihood for the phenotypes, and these could be easily identified in the trees. Inclusion of CO diffusing capacity revealed the transfer coefficient as dominant measure. The results of machine learning were consistent with those of the single trees. Conclusions Selected items (cough, sleep, breathlessness, chest condition, slow walking) from comprehensive COPD questionnaires in combination with FEV1/FVC could raise or lower the likelihood for lung emphysema in patients with COPD. The simple, parsimonious approach proposed by us might help if diagnostic resources regarding respiratory diseases are limited. Trial registration ClinicalTrials.gov, Identifier: NCT01245933, registered 18 November 2010, https://clinicaltrials.gov/ct2/show/record/NCT01245933Test. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01837-2. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5365e5b75d58e176b8f572b5114e3bf7Test https://doaj.org/article/7abfe002a0824d03b457586791eb9846Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....5365e5b75d58e176b8f572b5114e3bf7 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |