Information de reference pour ce titreAccession Number: | 00019521-201102010-00008.
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Author: | Leidy, Nancy K. 1; Wilcox, Teresa K. 1; Jones, Paul W. 2; Roberts, Laurie 1; Powers, John H. 3; Sethi, Sanjay 4; the EXACT-PRO Study Group
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Institution: | (1)United BioSource Corporation, Bethesda, Maryland; (2)St. George's Hospital, University of London, London, United Kingdom; (3)George Washington University, Washington, District of Columbia; and (4)University at Buffalo, SUNY, Buffalo, New York
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Title: | |
Source: | American Journal of Respiratory & Critical Care Medicine. 183(3):323-329, February 1, 2011.
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Abstract: | Rationale: Although exacerbations are an important problem in chronic obstructive pulmonary disease (COPD) and a target of intervention, there is no valid, standardized tool for assessing their frequency, severity, and duration.
Objectives: This study tested the properties of the Exacerbations of Chronic Pulmonary Disease Tool (EXACT), a new patient-reported outcome diary.
Methods: A prospective, two-group, observational study was conducted in patients with COPD. The acute group (n = 222) was enrolled during a clinic visit for exacerbation with follow-up visits on Days 10, 29, and 60. The stable group (n = 188), recruited by telephone or during routine visits, was exacerbation free for at least 60 days.
Measurements and Main Results: Acute patients completed the diary on Days 1-29 and 60-67; stable patients for 7 days. All patients provided stable-state spirometry and completed the St. George Respiratory Questionnaire-COPD (SGRQ-C). Acute patient assessments included clinician and patient global ratings of exacerbation severity and recovery. Mean age of the sample (n = 410) was 65 (+/- 10) years; 48% were male; stable FEV1 was 51% predicted (+/- 20). Internal consistency (Pearson separation index) for the EXACT was 0.92, 1-week reproducibility (stable patients; intraclass correlation) was 0.77. EXACT scores correlated with SGRQ-C (r = 0.64; P < 0.0001) and differentiated acute and stable patients (P < 0.0001). In acute patients, scores improved over time (P < 0.0001) and differentiated between degrees of clinician-rated exacerbation severity (P < 0.05). EXACT change scores differentiated responders and nonresponders on Day 10, as judged by clinicians or patients (P < 0.0001).
Conclusions: Results suggest the EXACT is reliable, valid, and sensitive to change with exacerbation recovery.
(C) 2011 American Thoracic Society
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Author Keywords: | exacerbation; COPD; symptoms; diary; patient-reported outcomes.
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Language: | English.
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Document Type: | Article: PDF Only.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1073-449X
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NLM Journal Code: | 9421642, bzs
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DOI Number: | https://dx.doi.org/10.1164/rccm....- ouverture dans une nouvelle fenêtre
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