The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Ramon, Maria Antonia
• dc.contributor.author Ter Riet, Gerben
• dc.contributor.author Carsin, Anne-Elie
• dc.contributor.author Gimeno Santos, Elena, 1980-
• dc.contributor.author Agustí García-Navarro, Àlvar
• dc.contributor.author Antó i Boqué, Josep Maria
• dc.contributor.author Donaire González, David
• dc.contributor.author Ferrer, Jaume
• dc.contributor.author Rodríguez, Esther
• dc.contributor.author Rodríguez-Roisin, Robert
• dc.contributor.author Puhan, Milo A.
• dc.contributor.author García Aymerich, Judith
• dc.date.accessioned 2019-07-22T08:01:11Z
• dc.date.issued 2018
• dc.description.abstract The vicious circle of dyspnoea-inactivity has been proposed, but never validated empirically, to explain the clinical course of chronic obstructive pulmonary disease (COPD). We aimed to develop and validate externally a comprehensive vicious circle model.We utilised two methods. 1) Identification and validation of all published vicious circle models by a systematic literature search and fitting structural equation models to longitudinal data from the Spanish PAC-COPD (Phenotype and Course of COPD) cohort (n=210, mean age 68 years, mean forced expiratory volume in 1 s (FEV1) 54% predicted), testing both the hypothesised relationships between variables in the model ("paths") and model fit. 2) Development of a new model and external validation using longitudinal data from the Swiss and Dutch ICE COLD ERIC (International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts) cohort (n=226, mean age 66 years, mean FEV1 57% predicted).We identified nine vicious circle models for which structural equation models confirmed most hypothesised paths but showed inappropriate fit. In the new model, airflow limitation, hyperinflation, dyspnoea, physical activity, exercise capacity and COPD exacerbations remained related to other variables and model fit was appropriate. Fitting it to ICE COLD ERIC, all paths were replicated and model fit was appropriate.Previously published vicious circle models do not fully explain the vicious circle concept. We developed and externally validated a new comprehensive model that gives a more relevant role to exercise capacity and COPD exacerbations.
• dc.format.mimetype application/pdf
• dc.identifier.citation Ramon MA, Ter Riet G, Carsin AE, Gimeno-Santos E, Agustí A, Antó JM et al. The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model. Eur Respir J. 2018;52(3):1800079. DOI: 10.1183/13993003.00079-2018
• dc.identifier.doi http://dx.doi.org/10.1183/13993003.00079-2018
• dc.identifier.issn 0903-1936
• dc.identifier.uri http://hdl.handle.net/10230/42130
• dc.language.iso eng
• dc.publisher European Respiratory Society
• dc.relation.ispartof European Respiratory Journal. 2018;52(3):1800079
• dc.rights This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available at http://dx.doi.org/10.1183/13993003.00079-2018.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.title The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion