New model found to help predict 20-year risk of COPD
Prediction of future lung function could let clinicians identify those at high risk for chronic obstructive pulmonary disease (COPD), but the trajectory of lung function decline varies greatly among individuals, the authors noted.
Researchers developed a model to identify patients at increased risk of chronic obstructive pulmonary disease (COPD), as well as to predict long-term lung function trajectories and risk of airflow limitation.
The model was developed and validated using data from the Framingham Offspring Cohort, which included 4,167 participants 20 years of age or older who had two or more valid spirometry assessments. The researchers created mixed-effects regression models for individualized prediction and used a machine-learning algorithm to determine essential predictors, then validated the model using data from two large, independent multicenter cohorts (Coronary Artery Risk Development in Young Adults, [n=2,075] and Atherosclerosis Risk in Communities [n=12,913]). The results were published Sept. 19 by CHEST.
The primary outcome was pre-bronchodilator forced expiratory volume at 1 second (FEV1). The secondary outcome was the risk of airflow limitation (defined as FEV1/forced vital capacity less than lower limit of normal). Using 20 common predictors, the model explained 79% of variation in FEV1 decline in the derivation cohort. In two validation datasets, the model had low error in predicting FEV1 decline (root mean square error range, 0.18 to 0.22 L) and high discriminative power in predicting risk of airflow limitation (C statistic range, 0.86 to 0.87).
The study authors noted that clinical prediction tools are critical for personalized care, and preventive management based on objective risk prediction has high potential to reduce the risk and burden of COPD.
“Researchers have envisaged that the clinical course of COPD can be modified by preventive strategies at early stage,” the authors wrote. “This easy-to-implement tool can be harnessed to identify individuals at a high risk of developing COPD, and target them for closer monitoring and application of preventive and therapeutic interventions.”