Soler-Cataluña, J.J. (Juan José)
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- New GOLD classification: longitudinal data on group assignment(BioMed Central, 2014) Ramos, P. (Pilar); Galdiz, J.B. (Juan Bautista); Cosio, B.G. (Borja G.); Martinez-Gonzalez, C. (Cristina); Casanova, C. (Ciro); Soler-Cataluña, J.J. (Juan José); Agüero, R. (Ramón); Marin, J.M. (José M.); Calle-Rubio, M. (Miryam); Marin, M. (Margarita); Torres, J.P. (Juan P.) de; Irigaray, R. (Rosa); Soriano, J.B. (Joan B.); Diego-Damia, A. (Alfredo) de; Solanes-García, I. (Ingrid); Feu-Collado, N. (Nuria); Balcells, E. (Eva); Llunell, A. (Antonia); Lopez-Campos, J.L. (José Luis); Alfageme, I. (Inmaculada); Mir-Viladrich, I. (Isabel); Peces-Barba, G. (German)In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index.
- Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data(European respiratory society, 2020) Sobradillo, P. (Patricia); Sternberg, A. (Alice); Esteban, C. (Cristóbal); Navarro, A. (Annie); Cosio, B.G. (Borja G.); Johannessen, A. (Ane); García-Castillo, E. (Elena); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Han, M.K. (Meilan K.); Burgel, P.R.(Pierre-Régis); Soler-Cataluña, J.J. (Juan José); Ramírez-García-Luna, A.S. (Ana S.); Lamprecht, B. (Bernd); Turner, A.M. (Alice M.); Ancochea-Bermúdez, J. (Julio); García-Aymerich, J. (Judith); Marin, J.M. (José M.); Langhammer, A. (Arnulf); Oga, T. (Toru); Almagro, P. (Pere); Torres, J.P. (Juan P.) de; Soriano, J.B. (Joan B.); Carrasco, L. (Laura); Bakke, P. (Per); Alonso-Pérez, T. (Tamara); Roche, N. (Nicolás); Aalberg-Vikjord, S.A. (Sigrid Ana); Martinez-Camblor, P. (Pablo); Leivseth, L. (Linda); Miravitlles, M. (Marc); Pastor-Sanz, M.T. (Maria Teresa); Antó, J.M. (Josep M.); Lange, P. (Peter); Echazarreta, A. (Andrés); Puhan, M.A. (Milo A.); Kaiser, B. (Bernhard); Lopez-Campos, J.L. (José Luis); Alfageme, I. (Inmaculada); Sin, D.D. (Don D.); Rodríguez-Carballeira, M. (Mónica); Riet, G. (Gerben) terIn 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A–4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±sd age was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66–0.68) for GOLD 2015 and 0.65 (95% CI 0.63–0.66) for GOLD 2019.
- Large-scale external validation and comparison of prognostic models: an application to chronic obstructive pulmonary disease(2018) Sobradillo, P. (Patricia); Haile, S.R. (Sara R.); Esteban, C. (Cristóbal); 3CIA collaboration; Cosio, B.G. (Borja G.); Johannessen, A. (Ane); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Han, M.K. (Meilan K.); Ramirez, A.S. (Ana S.); Burgel, P.R.(Pierre-Régis); Soler-Cataluña, J.J. (Juan José); Lamprecht, B. (Bernd); Turner, A.M. (Alice M.); Ancochea-Bermúdez, J. (Julio); García-Aymerich, J. (Judith); Marin, J.M. (José M.); Langhammer, A. (Arnulf); Oga, T. (Toru); Almagro, P. (Pere); Torres, J.P. (Juan P.) de; Soriano, J.B. (Joan B.); Bakke, P. (Per); Guerra, B. (Beniamino); Roche, N. (Nicolás); Martinez-Camblor, P. (Pablo); Leivseth, L. (Linda); Miravitlles, M. (Marc); Antó, J.M. (Josep M.); Lange, P. (Peter); Echazarreta, A. (Andrés); Puhan, M.A. (Milo A.); Kaiser, B. (Bernhard); Alfageme, I. (Inmaculada); Sin, D.D. (Don D.); Riet, G. (Gerben) terBackground: External validations and comparisons of prognostic models or scores are a prerequisite for their use in routine clinical care but are lacking in most medical fields including chronic obstructive pulmonary disease (COPD). Our aim was to externally validate and concurrently compare prognostic scores for 3-year all-cause mortality in mostly multimorbid patients with COPD. Methods: We relied on 24 cohort studies of the COPD Cohorts Collaborative International Assessment consortium, corresponding to primary, secondary, and tertiary care in Europe, the Americas, and Japan. These studies include globally 15,762 patients with COPD (1871 deaths and 42,203 person years of follow-up). We used network meta-analysis adapted to multiple score comparison (MSC), following a frequentist two-stage approach; thus, we were able to compare all scores in a single analytical framework accounting for correlations among scores within cohorts. We assessed transitivity, heterogeneity, and inconsistency and provided a performance ranking of the prognostic scores. Results: Depending on data availability, between two and nine prognostic scores could be calculated for each cohort. The BODE score (body mass index, airflow obstruction, dyspnea, and exercise capacity) had a median area under the curve (AUC) of 0.679 [1st quartile-3rd quartile = 0.655-0.733] across cohorts. The ADO score (age, dyspnea, and airflow obstruction) showed the best performance for predicting mortality (difference AUC(ADO) - AUC(BODE) = 0.015 [95% confidence interval (CI) = - 0.002 to 0.032]; p = 0.08) followed by the updated BODE (AUCBODE updated - AUCBODE = 0.008 [95% CI = -0.005 to +0.022]; p = 0.23). The assumption of transitivity was not violated. Heterogeneity across direct comparisons was small, and we did not identify any local or global inconsistency. Conclusions: Our analyses showed best discriminatory performance for the ADO and updated BODE scores in patients with COPD. A limitation to be addressed in future studies is the extension of MSC network meta-analysis to measures of calibration. MSC network meta-analysis can be applied to prognostic scores in any medical field to identify the best scores, possibly paving the way for stratified medicine, public health, and research.
- Finding the best thresholds of FEV1 and dyspnea to predict 5-year survival in COPD patients: the COCOMICS study(Public Library of Science, 2014) Esteban, C. (Cristóbal); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Soler-Cataluña, J.J. (Juan José); Marin, J.M. (José M.); Almagro, P. (Pere); Torres, J.P. (Juan P.) de; Soriano, J.B. (Joan B.); Martinez-Camblor, P. (Pablo); Miravitlles, M. (Marc); Alfageme, I. (Inmaculada)BACKGROUND: FEV1 is universally used as a measure of severity in COPD. Current thresholds are based on expert opinion and not on evidence. OBJECTIVES: We aimed to identify the best FEV1 (% predicted) and dyspnea (mMRC) thresholds to predict 5-yr survival in COPD patients. DESIGN AND METHODS: We conducted a patient-based pooled analysis of eleven COPD Spanish cohorts (COCOMICS). Survival analysis, ROC curves, and C-statistics were used to identify and compare the best FEV1 (%) and mMRC scale thresholds that predict 5-yr survival. RESULTS: A total of 3,633 patients (93% men), totaling 15,878 person-yrs. were included, with a mean age 66.4 ± 9.7, and predicted FEV1 of 53.8% (± 19.4%). Overall 975 (28.1%) patients died at 5 years. The best thresholds that spirometrically split the COPD population were: mild ≥ 70%, moderate 56-69%, severe 36-55%, and very severe ≤ 35%. Survival at 5 years was 0.89 for patients with FEV1 ≥ 70 vs. 0.46 in patients with FEV1 ≤ 35% (H.R: 6; 95% C.I.: 4.69-7.74). The new classification predicts mortality significantly better than dyspnea (mMRC) or FEV1 GOLD and BODE cutoffs (all p<0.001). Prognostic reliability is maintained at 1, 3, 5, and 10 years. In younger patients, survival was similar for FEV1 (%) values between 70% and 100%, whereas in the elderly the relationship between FEV1 (%) and mortality was inversely linear. CONCLUSIONS: The best thresholds for 5-yr survival were obtained stratifying FEV1 (%) by ≥ 70%, 56-69%, 36-55%, and ≤ 35%. These cutoffs significantly better predict mortality than mMRC or FEV1 (%) GOLD and BODE cutoffs.
- What pulmonologists think about the asthma–COPD overlap syndrome(Dove Medical Press, 2015) Perez-de-Llano, L. (Luis); Torrego, A. (Alfons); Esteban, C. (Cristóbal); Cosio, B.G. (Borja G.); Ros, J.A. (José Antonio); Casanova, C. (Ciro); Iriberri, M. (Milagros); Garcia-Sidro, P. (Patricia); Cisneros, C. (Carolina); Soler-Cataluña, J.J. (Juan José); Urrutia, I. (Isabel); Calle-Rubio, M. (Miryam); Alcazar, B. (Bernardino); Alvarez, F.J. (Francisco Javier); Izquierdo, J.L. (José Luis); Bazus, T. (Teresa); Perpiña, M. (Miguel); Torres, J.P. (Juan P.) de; Lopez-Viña, A. (Antolín); Entrenas, L.M. (Luis M.); Serrano, J. (José); Miravitlles, M. (Marc); Huerta, A. (Arturo); Plaza, V. (Vicente); Martinez-Moragon, E. (Eva); Lopez-Campos, J.L. (José Luis)Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma–COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity ,0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting β2-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting β2-agonist/inhaled corticosteroids.