Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation最新文献

{"title":"Outcomes of Virtual Pulmonary Rehabilitation in Oxygen-Dependent COPD Patients.","authors":"Hector Filizola, Anirudh Kumar, Russell G Buhr, Kristin Schwab Jensen","doi":"10.15326/jcopdf.2024.0572","DOIUrl":"10.15326/jcopdf.2024.0572","url":null,"abstract":"<p><p>Virtual pulmonary rehabilitation (PR) is a proven yet underutilized intervention in chronic obstructive pulmonary disease (COPD) patients. However, neither the safety nor the effectiveness of virtual PR is established for patients with advanced disease and higher disease severity, particularly those requiring supplemental oxygen. We performed a retrospective review of 167 patients to evaluate the feasibility, safety, and effectiveness of virtual PR in oxygen-dependent versus nonoxygen-dependent COPD patients. Our primary outcome, attendance, was high (88% of sessions were attended by both groups). Adverse events occurred in only 2 (1%) participants, one in each group. Both groups showed significant postintervention improvements in dyspnea and depression scores (COPD Assessment Test [CAT], modified Medical Research Council [mMRC], Patient Health Questionnaire-9 [PHQ-9]) and functional exercise capacity (1-minute sit-to-stand [1MSTS]), with the improvements approaching or exceeding the established minimal clinically important difference values. When comparing the oxygen-dependent and nonoxygen groups, there were no significant differences in the degree of improvement for CAT, PHQ-9, and 1MSTS. For mMRC, those on oxygen did improve by 0.3 less than those not on oxygen (<i>P</i>=0.052). These findings suggest virtual PR is safe and effective for COPD patients requiring oxygen. To our knowledge, this is the first study to compare outcomes of virtual PR in patients on and off oxygen. Future research should explore patient-specific factors that can further individualize care.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"184-189"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Chart Review and Administrative Data in Developing Predictive Models for Readmissions in Chronic Obstructive Pulmonary Disease.","authors":"Sukarn Chokkara, Michael G Hermsen, Matthew Bonomo, Samuel Kaskovich, Maximilian J Hemmrich, Kyle A Carey, Laura Ruth Venable, Juan C Rojas, Matthew M Churpek, Valerie G Press","doi":"10.15326/jcopdf.2024.0542","DOIUrl":"10.15326/jcopdf.2024.0542","url":null,"abstract":"<p><p>This study aimed to evaluate the performance of machine learning models for predicting readmission of patients with chronic obstructive pulmonary disease (COPD) based on administrative data and chart review data. The study analyzed 4327 patient encounters from the University of Chicago Medicine to assess the risk of readmission within 90 days after an acute exacerbation of COPD. Two random forest prediction models were compared. One was derived from chart review data, while the other was derived using administrative data. The data were randomly partitioned into training and internal validation sets using a 70% to 30% split. The 2 models had comparable accuracy (administrative data area under the curve [AUC]=0.67, chart review AUC=0.64). These results suggest that despite its limitations in precisely identifying COPD admissions, administrative data may be useful for developing effective predictive tools and offer a less labor-intensive alternative to chart reviews.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"175-183"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Recording in Electronic Health Records: A Systematic Review.","authors":"Elizabeth Moore, Philip Stone, Ayda Alizadeh, Jaspreet Sangha, Saranya Das, Shraddha Arshanapalli, Jennifer K Quint","doi":"10.15326/jcopdf.2024.0577","DOIUrl":"10.15326/jcopdf.2024.0577","url":null,"abstract":"<p><strong>Objective: </strong>Acute exacerbations of COPD(AECOPD) can have severe impacts on patients with the disease and a heavy burden on health care resources. Electronic health records (EHRs) are a valuable resource for identifying cases of AECOPD and research. Studies have attempted to validate case definitions of AECOPD and this review aims to summarize validated AECOPD definitions in EHRs and to provide guidance on the best algorithms to use to ensure accurate cohorts of AECOPD cases are available for researchers using EHRs.</p><p><strong>Methods: </strong>MEDLINE and Embase were searched and studies that met the inclusion criteria were reviewed by ≥2 reviewers. Data extracted included the algorithms used to identify AECOPD, the reference standards used to compare against the algorithm, and measures of validity. The risk of bias was assessed using QUADAS-2 adapted for this review.</p><p><strong>Results: </strong>Out of 2784 studies found by the search strategy, 12 met the inclusion criteria. The clinical terminology used to build algorithms to detect AECOPD included codes from the International Classification of Diseases (ICD) Ninth Revision, Clinical Modification and Tenth Revision (ICD-9-CM and ICD-10), along with the Read codes from United Kingdom general practices. AECOPD can be identified within EHRs using validated definitions, however, the validity of AECOPD definitions varies considerably depending on the algorithm used and the settings to which they are applied.</p><p><strong>Conclusion: </strong>Although there are validated definitions that can be used to identify AECOPD, there is no clear consensus on which provides the highest validity or the most sensitive and specific definition to use.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"190-202"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Stress is Associated with Health Outcomes, Platelet Activation, and Oxidative Stress in COPD.","authors":"Obiageli Offor, Michelle N Eakin, Han Woo, Daniel Belz, Marlene Williams, Sarath Raju, Meredith McCormack, Nadia N Hansel, Nirupama Putcha, Ashraf Fawzy","doi":"10.15326/jcopdf.2024.0561","DOIUrl":"10.15326/jcopdf.2024.0561","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic obstructive pulmonary disease (COPD) are disproportionately affected by social determinants of health that have been associated with worse respiratory outcomes. This study evaluates the association of perceived stress with respiratory outcomes and distinct biological mechanisms among former smokers with COPD.</p><p><strong>Methods: </strong>Participants were assessed in an observational study at baseline, 3-months, and 6-months. Questionnaires assessed perceived stress (Perceived Stress Scale, [PSS]), respiratory symptoms, and incidence of COPD exacerbations. Generalized linear mixed models evaluated the association of PSS score with COPD outcomes and biomarkers of platelet activation (urine 11-dehydro-thromboxane B2 [11dTxB2]), oxidative stress (urine thiobarbituric acid reactive substances [TBARS], 8- hydroxydeoxyguanosine, and 8-isoprostane), and inflammation.</p><p><strong>Results: </strong>Among 99 participants, the median PSS score was 13 (interquartile range 8-18) across all visits. Compared with low perceived stress (PSS 0-13), moderate (PSS 14-26) and high perceived stress (PSS 27-40) were associated with worse respiratory health status and respiratory-related quality of life, with point estimates for high perceived stress exceeding clinically important differences. Only high PSS was associated with increased moderate/severe exacerbations (odds ratio 4.15, 95% confidence interval [CI]: 1.28-13.47). Compared to low stress, high stress was associated with lower TBARS (β=-25.5%, 95%CI: -43.8- -1.2%) and higher 8-isoprostane (β=40.1%, 95%CI: 11.5-76.0%). Among individuals with mild-moderate COPD, compared to low stress, moderate (β=20.1%, 95%CI: 3.1-40.0%) and high (β=52.9%, 95%CI: 22.1-91.6%) stress were associated with higher 11dTxB2.</p><p><strong>Conclusion: </strong>Among former smokers with COPD, higher perceived stress is associated with worse respiratory outcomes. Platelet activation and oxidative stress may be biological pathways through which perceived stress plays a role in COPD.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"98-108"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalized Non-Tuberculous Mycobacterial Pulmonary Disease Patients and Their Outcomes in the United States: A Retrospective Study Using National Inpatient Sample Data.","authors":"Saqib H Baig, Shruti Sirapu, Jesse Johnson","doi":"10.15326/jcopdf.2024.0568","DOIUrl":"10.15326/jcopdf.2024.0568","url":null,"abstract":"<p><strong>Background: </strong>Nontuberculous mycobacteria pulmonary disease (NTM-PD) is an emerging public health concern with increasing incidence and prevalence. Despite its chronic and progressive nature, there is a notable gap in research on the factors influencing hospital outcomes in this patient population.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study using data from the National Inpatient Sample (NIS) to analyze hospitalizations of adult patients diagnosed with NTM-PD. We examined patient demographics, comorbidities, and hospital characteristics to identify predictors of hospital length of stay (LOS) and discharge disposition. Multivariate negative binomial regression and logistic regression models were employed to assess the impact of these variables.</p><p><strong>Results: </strong>The study included 1167 hospitalized NTM-PD patients, with a mean age of 66.9 years. The overall mean LOS was 7.4 days, with an average hospital cost of $15,606. Discharge to a nursing home was associated with a 78% longer LOS (incidence rate ratio=1.78, <i>p</i><0.0001). Key predictors of extended LOS included male gender, private insurance status, higher comorbidity burden, and increased number of procedures. Patients discharged to nursing homes were more likely to be older males with complex medical profiles. Interestingly, conditions such as malignancy and COPD, while linked to longer LOS, were associated with a decreased likelihood of discharge to a nursing home.</p><p><strong>Conclusion: </strong>Our study highlights significant predictors of LOS and discharge outcomes in NTM-PD patients, emphasizing the need for personalized and proactive management. These findings underscore the importance of targeted interventions in the outpatient setting to reduce hospital admissions and improve patient outcomes.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"146-157"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Nomogram for Predicting the Risk of Acute Heart Failure in Intensive Care Unit Patients with COPD.","authors":"Ziyang Wu, Sutong Zhan, Dong Wang, Chengchun Tang","doi":"10.15326/jcopdf.2024.0562","DOIUrl":"10.15326/jcopdf.2024.0562","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to construct a prediction model to assess the onset of acute heart failure (AHF) in patients with chronic obstructive pulmonary disease (COPD) without a history of heart failure and to evaluate the predictive value of the nomogram.</p><p><strong>Methods: </strong>This study involved 3730 patients with COPD and no history of heart failure. Clinical and laboratory data were collected from the Medical Information Mart for Intensive Care IV database. The patients were divided into a training set (2611 cases) and a validation set (1119 cases) in a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression was used to identify potential risk factors for AHF in patients with COPD. These factors were then subjected to multivariate logistic regression analysis to develop a prediction model for the risk of AHF. The model's differentiation, consistency, and clinical applicability were evaluated using receiver operating characteristic analysis, a calibration curve, and decision curve analysis (DCA), respectively.</p><p><strong>Results: </strong>LASSO regression identified 10 potential predictors. The concordance index was 0.820. The areas under the curves for the training and validation sets were 0.8195 and 0.8035, respectively. The calibration curve demonstrated strong concordance between the nomogram's predictions and the actual outcomes. DCA confirmed the clinical applicability of the nomogram.</p><p><strong>Conclusion: </strong>Our nomogram is a reliable and convenient tool for predicting acute heart failure in patients with COPD.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"117-126"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications of <i>Pseudomonas Aeruginosa</i> Colonization in Chronic Obstructive Pulmonary Disease Patients.","authors":"Wang Chun Kwok, Terence Chi Chun Tam, Chi Hung Chau, Fai Man Lam, James Chung Man Ho","doi":"10.15326/jcopdf.2024.0582","DOIUrl":"10.15326/jcopdf.2024.0582","url":null,"abstract":"<p><strong>Background: </strong><i>Pseudomonas aeruginosa</i> is an important pathogen in patients with chronic respiratory diseases. It can colonize the airways and could have prognostic value in bronchiectasis and cystic fibrosis. Its role in chronic obstructive pulmonary disease (COPD) is less well-defined.</p><p><strong>Methods: </strong>A prospective study was conducted in Hong Kong to investigate the possible association between <i>Pseudomonas aeruginosa</i> colonization and acute exacerbation of COPD (AECOPD) risks.</p><p><strong>Results: </strong>Among 327 Chinese patients with COPD, 33 (10.1%) of the patients had <i>Pseudomonas aeruginosa</i> colonization. Patients with or without <i>Pseudomonas aeruginosa</i> colonization had similar background characteristics. Patients with <i>Pseudomonas aeruginosa</i> colonization had increased risks of moderate to severe AECOPD, severe AECOPD, and pneumonia with an adjusted odds ratio (aOR) of 3.15 (95% CI 1.05-9.48, <i>p</i>=0.042), 2.59 (95% CI 1.01₋6.64, <i>p</i>=0.048), and 4.19 (95% CI 1.40₋12.54, <i>p</i>=0.011) respectively. Patients with <i>Pseudomonas aeruginosa</i> colonization also had increased annual frequency of moderate to severe AECOPDs, median 0 (0₋0.93) in the non-<i>Pseudomonas aeruginosa</i> colonization group and 1.35 (0₋3.39) in the <i>Pseudomonas aeruginosa</i> colonization group, with a <i>p</i>-value of 0.005 in multivariate linear regression.</p><p><strong>Conclusion: </strong><i>Pseudomonas aeruginosa</i> colonization is a potential independent risk factor for moderate to severe AECOPD and pneumonia among patients with COPD without coexisting bronchiectasis.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"137-145"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Onset and Burden in Patients With Chronic Bronchitis and COPD: A Real-World Evidence Study.","authors":"Jamuna K Krishnan, Gerard J Criner, Bilal H Lashari, Fernando J Martinez, Victor Kim, Arthur Lindoulsi, Edward Khokhlovich, Pablo Altman, Helene Karcher, Matthias Schoenberger","doi":"10.15326/jcopdf.2024.0565","DOIUrl":"10.15326/jcopdf.2024.0565","url":null,"abstract":"<p><strong>Background: </strong>Chronic bronchitis (CB), classically defined as having cough and sputum production for at least 3 months per year for 2 consecutive years, is frequently associated with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>This retrospective cohort study using the Optum^® de-identified electronic health record data set (Optum^® EHR) aimed to identify patients with CB, COPD, and both CB and COPD through the application of the classical definition of CB, and to compare the characteristics of these populations, and the timing of diagnosis as well as their health care resource utilization (HCRU). Scanning of the EHRs was performed electronically using a specially developed algorithm.</p><p><strong>Results: </strong>Of 104,633,876 patients in the study period between January 2007 and September 2020, 628,545 patients had CB only (i.e., nonobstructive disease), 129,084 had COPD only (COPD cohort), and 77,749 had both COPD and CB (COPD-CB cohort). A total of 75.9% of patients (59,009 of 77,749) fulfilled the criteria for a CB diagnosis before their first diagnosis with COPD, compared with 24.1% who had COPD before being diagnosed with CB. HCRU over 5 years was highest in the COPD-CB cohort, whereas the COPD cohort and CB cohorts had similar HCRU over 5 years. The COPD-CB cohort had a greater percentage of common COPD comorbidities and exposure to more drug classes than the other cohorts.</p><p><strong>Conclusions: </strong>These results highlight the importance of increased attention to CB. CB often precedes the diagnosis of COPD and subsequently leads to high HCRU. Interventions to better manage CB and prevent the progression of CB to COPD could improve morbidity in this population.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"127-136"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in Prevalence and Burden of Chronic Obstructive Pulmonary Disease by State and Insurance Type in the United States.","authors":"Carol Bazell, Maggie Alston, Norbert Feigler, Hayley D Germack, Stephanie Leary, Winston Fopalan, David Mannino","doi":"10.15326/jcopdf.2024.0560","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0560","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) poses a substantial burden on individuals and the U.S. health care system. Up-to-date information describing individuals with COPD and their acute hospital-based health care utilization at the state level and by insurance type is lacking.</p><p><strong>Methods: </strong>Individuals with COPD aged 40 and older were identified from large databases of Medicare fee-for-service, Medicaid, and commercial health insurance claims, and counts were extrapolated to the U.S. health insurance market. Demographics and outcome metrics were quantified between January 1 and December 31, 2021, and summarized by state and insurance type.</p><p><strong>Results: </strong>Approximately 11.7 million insured individuals had COPD in 2021. The largest share were covered by Medicare (79.4%), followed by commercial insurance (11.3%) and Medicaid (9.3%). COPD prevalence varied among states, ranging from 44 (Utah) to 143 (West Virginia) per 1000 insured individuals. Nationwide, annual all-cause mortality for individuals with COPD covered by Medicare (11.5%) was more than double that of Medicaid (5.1%). There were 1.8 million COPD-related acute inpatient hospitalizations nationwide, with the largest share among individuals covered by Medicare (86.4%), followed by Medicaid (9.0%) and commercial insurance (4.6%). COPD-related hospitalization rates also varied among states, ranging from 97 (Idaho) to 200 (District of Columbia) per 1000 individuals with COPD. There were 1.4 million COPD-related emergency department/observation encounters not resulting in acute inpatient admissions nationwide.</p><p><strong>Conclusion: </strong>There is substantial state and payer variation in COPD prevalence and burden. Understanding this variation provides valuable insights into populations with unmet needs that can inform public health strategies to address gaps.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":"12 2","pages":"158-174"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal and Validation of the Minimum Clinically Important Difference in Emphysema Progression.","authors":"Emily S Y Ho, Paul R Ellis, Diana Kavanagh, Deepak Subramanian, Robert A Stockley, Alice M Turner","doi":"10.15326/jcopdf.2024.0511","DOIUrl":"10.15326/jcopdf.2024.0511","url":null,"abstract":"<p><strong>Objective: </strong>The severity of emphysema may be measured by lung density on computed tomography (CT) scanning, and in alpha-1 antitrypsin deficiency (AATD) this measure has been used as the primary outcome in trials of disease-modifying therapy, namely augmentation. However, the minimum clinically important difference (MCID) in lung density change is not known; this study aimed to derive and validate MCIDs for density values in AATD.</p><p><strong>Methods: </strong>The distribution method and anchoring density against forced expiratory volume in 1 second (FEV₁) were used to derive mean and 95% confidence intervals for the MCID. Data from systematic reviews of CT density measurement and therapy for AATD obtained both absolute and annual changes in lung density. Using the range of potential MCID generated by these methods, a value was chosen for validation against mortality, lung function, and health status in the Birmingham, United Kingdom AATD cohort, using regression to adjust for confounders.</p><p><strong>Results: </strong>Anchor and distribution methods generated a probable MCID of -1.87 g/L/year (range -1.53 to -2.20). The greatest differences between groups were found at the -2.2g/L/year with a greater FEV₁ decline in individuals with greater lung loss. Absolute lung density change had a probable MCID of -2.04g/L (range -1.83 to -2.30), and there was a difference in lung function (<i>p</i><0.001) and mortality; where individuals whose absolute lung loss of more than -2.04g/L had a greater risk of death (<i>p</i><0.05).</p><p><strong>Interpretation: </strong>From initial evidence, we have shown absolute lung density change as a potential outcome for emphysema modifying therapies in AATD rather than annual density change, with an MCID of -2.04g/L.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"109-116"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}