In order to determine the severity of disease in a patient with COPD, doctors only need to know three things. A three-item index of lung function, dyspnoea (shortness of breath) and age can effectively estimate a patient’s risk of death within three years. Professor Karel Moons, who is an epidemiologist at University Medical Center (UMC) Utrecht, describes these results together with colleagues from the Academic Medical Center (AMC) Amsterdam and the Maastricht University Medical Center in an article published in The Lancet on August 29, 2009.
Through comparing 342 Spanish and 232 Swiss patients with COPD, an international team of doctors and epidemiologists examined which factors can predict a 3-year mortality risk. The researchers were able to reduce an existing index to a check list that contains just three items. As well as knowing the age of the patient, the doctor has to measure the lung function of the patient by using a simple breath test. Patients are also asked which kinds of exercise cause them to be short of breath. These three items can accurately predict whether a patient with COPD is at risk of dying within three years. The researchers have named the check list the ADO-index, which is an acronym for Age, Dyspnoea and airflow Obstruction.
Moons: “We hope that the simplicity of the ADO-index will ensure that not only specialists but also general practitioners will use it to estimate the prognosis of patients with COPD. It is really important both for doctors and patients to know what the probable course of the disease will be.”
COPD (chronic obstructive pulmonary disease) is a chronic obstruction of the airways and is one of the main causes of death worldwide. Smoking is one of the biggest causes of COPD but air pollution also contributes significantly. Patients with COPD often have chronic bronchitis and emphysema. The disease can be fatal at long term. There are approximately 300,000 people with the disease in the Netherlands.
Professor Karel Moons is affiliated to the Julius Center for Health Sciences and Primary Care at UMC Utrecht. As well as Professor Moons, Gerben ter Riet of AMC, and Alphons Kessels of Maastricht University Medical Center worked on this research. Epidemiologists and pulmonologists from Baltimore in the US, Barcelona and Zurich were responsible for setting up and conducting the study.