Jaromir Zatloukal, Eva Volakova, Jana Kovacikova, Martina Kulirova, Miroslav Maruscak, Blanka Hytychova, Vladimir Koblizek
{"title":"用于有效检测COPD加重史的新仪器，包括通常未报告的事件。","authors":"Jaromir Zatloukal, Eva Volakova, Jana Kovacikova, Martina Kulirova, Miroslav Maruscak, Blanka Hytychova, Vladimir Koblizek","doi":"10.3389/fmed.2025.1630338","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>COPD exacerbations are important events for disease management. The incidence of exacerbations impacts prognosis, guides treatment, and predicts future exacerbations. Despite their importance, exacerbations are often underdiagnosed and underreported. The aim of our study was to test and evaluate the effectiveness of a structured checklist for detecting past exacerbations that we developed and that would be suitable for routine clinical practice.</p><p><strong>Methods: </strong>350 patients with COPD and FEV<sub>1</sub> < 80% of the predicted value were enrolled in 35 centers. Each patient completed a structured checklist and underwent an interview with the physician. The number of exacerbations, their symptoms and duration, and the treatments were evaluated. Clinical data on exacerbations in the previous 12 months were retrieved from the patient's medical records and analyzed retrospectively. The data obtained using the structured checklist were compared with the data from the interviews and medical records.</p><p><strong>Results: </strong>Compared to the patient-physician interview, the structured checklist detected more exacerbations since the previous visit (<i>p</i> = 0.025). The difference was significant also for severe exacerbations (<i>p</i> = 0.003). In patients reporting only one event, the structured checklist was more sensitive in detecting mild events than the interview (<i>p</i> < 0.001). The structured checklist detected mild exacerbations in 10 patients in whom the interview detected none. Compared to the number of exacerbations in the medical records, the structured checklist detected more than twice as many events. The mean duration of an exacerbation was 9.7 days, and the most prominent symptoms were dyspnea and productive cough.</p><p><strong>Conclusion: </strong>Proposed structured checklist improved the detection of past exacerbations, including usually unreported events. Moreover, the structured checklist allows the severity and other clinical characteristics of past exacerbations to be specified and used to direct further COPD therapy.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1630338"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490996/pdf/","citationCount":"0","resultStr":"{\"title\":\"New instrument for effective detection of a history of COPD exacerbations, including usually unreported events.\",\"authors\":\"Jaromir Zatloukal, Eva Volakova, Jana Kovacikova, Martina Kulirova, Miroslav Maruscak, Blanka Hytychova, Vladimir Koblizek\",\"doi\":\"10.3389/fmed.2025.1630338\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>COPD exacerbations are important events for disease management. The incidence of exacerbations impacts prognosis, guides treatment, and predicts future exacerbations. Despite their importance, exacerbations are often underdiagnosed and underreported. The aim of our study was to test and evaluate the effectiveness of a structured checklist for detecting past exacerbations that we developed and that would be suitable for routine clinical practice.</p><p><strong>Methods: </strong>350 patients with COPD and FEV<sub>1</sub> < 80% of the predicted value were enrolled in 35 centers. Each patient completed a structured checklist and underwent an interview with the physician. The number of exacerbations, their symptoms and duration, and the treatments were evaluated. Clinical data on exacerbations in the previous 12 months were retrieved from the patient's medical records and analyzed retrospectively. The data obtained using the structured checklist were compared with the data from the interviews and medical records.</p><p><strong>Results: </strong>Compared to the patient-physician interview, the structured checklist detected more exacerbations since the previous visit (<i>p</i> = 0.025). The difference was significant also for severe exacerbations (<i>p</i> = 0.003). In patients reporting only one event, the structured checklist was more sensitive in detecting mild events than the interview (<i>p</i> < 0.001). The structured checklist detected mild exacerbations in 10 patients in whom the interview detected none. Compared to the number of exacerbations in the medical records, the structured checklist detected more than twice as many events. The mean duration of an exacerbation was 9.7 days, and the most prominent symptoms were dyspnea and productive cough.</p><p><strong>Conclusion: </strong>Proposed structured checklist improved the detection of past exacerbations, including usually unreported events. Moreover, the structured checklist allows the severity and other clinical characteristics of past exacerbations to be specified and used to direct further COPD therapy.</p>\",\"PeriodicalId\":12488,\"journal\":{\"name\":\"Frontiers in Medicine\",\"volume\":\"12 \",\"pages\":\"1630338\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490996/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fmed.2025.1630338\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1630338","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
New instrument for effective detection of a history of COPD exacerbations, including usually unreported events.
Background: COPD exacerbations are important events for disease management. The incidence of exacerbations impacts prognosis, guides treatment, and predicts future exacerbations. Despite their importance, exacerbations are often underdiagnosed and underreported. The aim of our study was to test and evaluate the effectiveness of a structured checklist for detecting past exacerbations that we developed and that would be suitable for routine clinical practice.
Methods: 350 patients with COPD and FEV1 < 80% of the predicted value were enrolled in 35 centers. Each patient completed a structured checklist and underwent an interview with the physician. The number of exacerbations, their symptoms and duration, and the treatments were evaluated. Clinical data on exacerbations in the previous 12 months were retrieved from the patient's medical records and analyzed retrospectively. The data obtained using the structured checklist were compared with the data from the interviews and medical records.
Results: Compared to the patient-physician interview, the structured checklist detected more exacerbations since the previous visit (p = 0.025). The difference was significant also for severe exacerbations (p = 0.003). In patients reporting only one event, the structured checklist was more sensitive in detecting mild events than the interview (p < 0.001). The structured checklist detected mild exacerbations in 10 patients in whom the interview detected none. Compared to the number of exacerbations in the medical records, the structured checklist detected more than twice as many events. The mean duration of an exacerbation was 9.7 days, and the most prominent symptoms were dyspnea and productive cough.
Conclusion: Proposed structured checklist improved the detection of past exacerbations, including usually unreported events. Moreover, the structured checklist allows the severity and other clinical characteristics of past exacerbations to be specified and used to direct further COPD therapy.
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
