- Nov 2022
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The EXACT has previously been used in conjunction with a personal digital assistant [14, 24] or smartphone[25].
25 Halpin DM, Laing-Morton T, Spedding S, et al. A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO. Prim Care Respir J 2011; 20: 324–331
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It is important to realize the difference between the definition of a disease and itsdiagnostic criteria (1). The defining characteristics of a disease are the commonproperties specifying the group of abnormal persons on whom the description of thedisease is based. The definition of a disease is important in communication.Diagnostic criteria are features of the disease chosen from its description thatare found by empirical research to best distinguish the disease from others whichresemble it. The diagnostic criteria may or may not include features of the definingcharacteristics and frequently include features that do not appear in the definition (1).
Definition vs Diagnosis
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ecause of global variability in the available resources to treat patients and local customsaffecting the criteria for hospital visits and admissions, there is substantial variability in reported ECOPD outcomes.(11)
Importantísimo leer
- Halpin DMG, Rabe AP, Loke WJ, et al. Epidemiology, Healthcare Resource Utilization, and Mortality of Asthma and COPD in COVID-19: A Systematic Literature Review and Meta-Analyses. J Asthma Allergy 2022; 15: 811-25
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Exacerbations of COPD are important events in the management of COPD because they negatively impact healthstatus, rates of hospitalization and readmission, and disease progression.(2,3)
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Annotators
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Combined initial COPD assessment
Punto a destacar: - A partir del 2011, se incluye el CAT y el mMRC para tomar en consideración los PROs para guiar el tratamiento en pacientes con COPD. - The newest change regarding this topic in the 2023 guide, is the modification from the ABCD to the ABE assessment tool. This approach recognizes the clinical relevance of exacerbations, independently of the level of symptoms of the patient. CD are joined and form the E, to highlight Exacerbations. This still has to be validated.
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The SGRQ is the most widely documented comprehensive measure; scores < 25 are uncommon in diagnosed COPDpatients(43) and scores ≥ 25 are very uncommon in healthy persons.(44,45) Therefore, it is recommended that a symptomscore equivalent to SGRQ score ≥ 25 should be used as the threshold for considering regular treatment for symptomsincluding breathlessness, particularly since this corresponds to the range of severity seen in patients recruited to thetrials that have provided the evidence base for treatment recommendations.
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The CAT™† is an 8-item questionnaire that assesses health status in patients with COPD (Figure).(41) It was developedto be applicable worldwide and validated translations are available in a wide range of languages. The score rangesfrom 0 to 40, correlates very closely with the SGRQ, and has been extensively documented in numerouspublications.(42)
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theimpact of disease on the patient’s health status, and the risk of future events
Los goals del COPD assessment según GOLD
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A diagnosis of COPD should be considered in any patient who has dyspnea, chronic cough orsputum production, a history of recurrent lower respiratory tract infections and/or a history ofexposure to risk factors for the disease, but forced spirometry showing the presence of a post-bronchodilator FEV1/FVC < 0.7 is mandatory to establish the diagnosis of COPD
Diagnóstico
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The realization that environmental factors other than tobacco smoking can contribute to COPD,that it can start early in life and affect young individuals, and that there are precursor conditions(Pre-COPD, PRISm
Importante leer
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