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COPD profiles and treatable traits using minimal resources: Identification, decision tree and longitudinal stability

2021Conference object Open access
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dc.contributor.authorMarques, Alda
dc.contributor.authorSouto-Miranda, Sara
dc.contributor.authorMachado, Ana
dc.contributor.authorOliveira, Ana
dc.contributor.authorJácome, Cristina
dc.contributor.authorCruz, Joana
dc.contributor.authorEnes, Vera
dc.contributor.authorAfreixo, Vera
dc.contributor.authorMartins, Vitória
dc.contributor.authorAndrade, L
dc.contributor.authorValente, Carla
dc.contributor.authorFerreira, Diva
dc.contributor.authorSimão, Paula
dc.contributor.authorBrooks, Dina
dc.contributor.authorTavares
dc.date.accessioned2022-01-04T14:32:51Z
dc.date.available2022-01-04T14:32:51Z
dc.date.issued2021
dc.description.abstractBackground: Chronic obstructive pulmonary disease (COPD) is highly heterogeneous and complex. Hence, personalising assessments and treatments to this population across different settings and available resources imposes challenges and debate. Research efforts have been made to identify clinical phenotypes or profiles for prognostic and therapeutic purposes. Nevertheless, such profiles often do not describe treatable traits, focus on complex physiological/pulmonary measures which are frequently not available across settings, lack validation and/or their stability over time is unknown. Objective: To identify profiles and their treatable traits based on simple and meaningful measures; to develop and validate a profile decision tree; and to explore profiles’ stability over time in people with COPD. Methods: An observational, prospective study was conducted with people with COPD. Clinical characteristics, lung function, symptoms, impact of the disease (COPD assessment test–CAT), health-related quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. Pulmonary and extrapulmonary (i.e., physical, symptoms and health status, and behavioural/life-style risk factors) treatable traits were identified in each profile based on the established cut-offs for each measure available in the literature. The decision tree was developed with 70% and validated with 30% of the sample, cross-sectionally. Agreement between the profile predicted by the decision tree and the profile defined by the clustering procedure was determined using Cohen’s Kappa. Stability was explored over time with a stability score defined as the percentage ratio between the number of timepoints that a participant was classified in the same profile (most frequent profile for that participant) and the total number of timepoints (i.e., 6). Results: 352 people with COPD (67.4±9.9 years; 78.1% male; FEV1=56.2±20.6% predicted) participated and 90 (67.6±8.9 years; 85.6% male; FEV1=52.1±19.9% predicted) were followed-up. Four profiles were identified with distinct treatable traits. The decision tree was composed by the CAT, age and FEV1% predicted and had an agreement of 71.7% (Cohen’s Kappa=0.62, p<0.001) with the actual profiles. 48.9% of participants remained in the same profile whilst 51.1% moved between two (47.8%) and three (3.3%) profiles over time. The overall stability of profiles was 86.8±15%. Conclusion: Profiles and treatable traits can be identified in people with COPD with simple and meaningful measures possibly available even in minimal-resource settings. Regular assessments are recommended as people with COPD may change profile over time and hence their needs of personalised treatment.pt_PT
dc.description.versionN/Apt_PT
dc.identifier.urihttp://hdl.handle.net/10400.8/6446
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectCOPDpt_PT
dc.subjectDPOCpt_PT
dc.subjectTreatable traitspt_PT
dc.subjectMinimal resourcespt_PT
dc.titleCOPD profiles and treatable traits using minimal resources: Identification, decision tree and longitudinal stabilitypt_PT
dc.title.alternativePerfis de DPOC e características tratáveis utilizando recursos mínimos: Identificação, árvore de decisão e estabilidade longitudinalpt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.conferencePlaceEPIC Sana Hotel - Centro de Congressos, Albufeirapt_PT
oaire.citation.title37º Congresso da Sociedade Portuguesa de Pneumologiapt_PT
person.familyNameMarques
person.familyNamePalos Souto de Miranda
person.familyNameCruz
person.familyNamede Almeida Andrade
person.familyNameSimão
person.familyNameBrooks
person.familyNameMarques de Pinho Tavares
person.givenNameAlda
person.givenNameSara
person.givenNameJoana
person.givenNameMaria Lília
person.givenNamePaula
person.givenNameDina
person.givenNameAna Helena
person.identifier6-LyBVIAAAAJ&hl=pt-PT&oi=ao
person.identifier.ciencia-idDE15-EFBA-4856
person.identifier.ciencia-idD21D-0290-5C3A
person.identifier.ciencia-idE213-7D20-5C3C
person.identifier.ciencia-idDD1B-7FC7-7981
person.identifier.ciencia-idC816-3B3E-32D7
person.identifier.orcid0000-0003-4980-6200
person.identifier.orcid0000-0002-5984-4844
person.identifier.orcid0000-0002-4911-4469
person.identifier.orcid0000-0003-2258-0643
person.identifier.orcid0000-0003-0070-2793
person.identifier.orcid0000-0001-6080-5052
person.identifier.orcid0000-0003-4632-3561
person.identifier.ridK-7030-2013
person.identifier.scopus-author-id36715922000
person.identifier.scopus-author-id56769057500
rcaap.rightsopenAccesspt_PT
rcaap.typeconferenceObjectpt_PT
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