Published date :
22 Aug 2008
MedWire News: The multidimensional BODE (Body mass index, airflow Obstruction, Dyspnea, Exercise capacity) index could be a reliable surrogate of disease survival for chronic obstructive pulmonary disease (COPD) patients who take part in therapeutic trials, US researchers report.
Reducing mortality is increasingly feasible in COPD, Fernando Martinez (University of Michigan Health System, Ann Arbor) and colleagues explain in the latest issue of the American Journal of Respiratory and Critical Care Medicine.
Consequently, therapeutic trials designed to demonstrate improved survival require large study design with extended follow-up periods, so there is a need to identify reliable surrogates of survival in COPD, the authors suggest.
Previous studies have shown multidimensional indices like the BODE index to predict outcomes more accurately than the individual components of the index. Martinez and team investigated whether a decrease in a modified BODE (mBODE) score would predict survival in 610 medically treated and 608 surgically treated COPD patients enrolled in the National Emphysema Treatment Trial (NETT).
mBODE scores and patient-specific mBODE trajectories were calculated during 6, 12, and 24 months of follow-up.
Martinez and team found that an increase in mBODE of >1 point was associated with subsequent mortality in surgically and medically treated patients, although surgically treated patients were less likely than medically treated patients to experience death or an increase of >1 in mBODE. Indices of concordance showed that mBODE change predicted survival better than its separate components.
"We demonstrate that a composite index (mBODE) demonstrates short- and intermediate- term responsiveness to intervention in severe COPD," the authors write.
They conclude that their findings "provide support that a short and intermediate change in a multidimensional composite index may be used as a surrogate for survival in clinical trials."
Current Medicine Group
作者:admin@医学,生命科学 2010-11-22 17:11