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Risk assessment for chronic ostructive pulmonary disease in orimary care: research should solve the dilemma

English title Risk assessment for chronic ostructive pulmonary disease in orimary care: research should solve the dilemma
Applicant Puhan Milo
Number 115216
Funding scheme Ambizione
Research institution Horten-Zentrum Universitätsspital Zürich
Institution of higher education University of Zurich - ZH
Main discipline Methods of Epidemiology and Preventive Medicine
Start/End 01.03.2007 - 28.02.2010
Approved amount 591'755.00
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All Disciplines (2)

Methods of Epidemiology and Preventive Medicine
Medical Statistics

Keywords (5)

primary care; COPD; assessment; prognosis; health status

Lay Summary (English)

Lay summary
The aim of this project is to develop and validate a practical disease severity index for patients with chronic obstructive pulmonary disease (COPD) in primary care settings that predicts the future course of the illness and serves as a basis for treatment selection.COPD is a systemic illness; morbidity and mortality due to this disease are on the increase, and it has great impact on patients’ lives. Most COPD patients are managed by general practitioners (GP). GPs base their assessment of patients’ disease severity mainly on lung function and then advise on adequate treatment to improve the patients’ health status. However, lung function alone is insufficient to assess disease severity and to predict the future course of the illness. Therefore, the European Respiratory Society and American Thoracic Society call for a COPD disease severity index that better represents the clinical manifestations of COPD.We will follow a bottom-up approach, which means that the future users of the disease severity index, GPs, will be closely involved throughout the development process to ensure its acceptability and applicability. We will conduct three linked prospective cohort studies with COPD patients (GOLD stages 2-4) from GPs in Switzerland, the Netherlands and, at a later stage, Canada. We will perform a sound baseline assessment including detailed patient history, lung function, measurement of exercise capacity and blood sampling. During the follow-up of at least two years, we update the patients’ profile by registering smoking status, symptoms, episodes with worsening of symptoms requiring an unplanned doctor visit (exacerbation) and health-related quality of life. Using multivariable regression analysis we will identify the best combination of variables predicting the course of health-related quality of life. Development and validation of a comprehensive yet practical disease severity index meets an urgent need. A bottom-up approach ensures that most patients will benefit from index-guided GP management. The study also opens perspectives for epidemiological studies to monitor COPD severity and clinical course over time. This will add substantially to the knowledge about COPD as one of the major diseases worldwide.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants


Associated projects

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173043 Investigating the interplay of job exposures, ambient air pollution and living environment as drivers of the chronic lung disease epidemic The Large-scale LuftiBus-SNC Cohort 01.01.2018 Project funding (special)