Development and Validation of a Quantitative Score for the Criteria Clinical Control in Stable COPD

Introduction: The control of Chronic Obstructive Pulmonary Disease (COPD) introduces a novel evaluative element in the management of COPD. There is a need for promoting its evaluation through a quantitative assessment to facilitate the interpretation of longitudinal changes. Objective: To develop a scoring system that quantitatively assesses the validated criteria defining the degree of COPD control. Methods: This study utilized data from the EPOCONSUL audit. Included were patients with documented COPD clinical control grades estimated and reported by physicians, and the necessary criteria to define clinical control degrees. Patients were randomly assigned to either the development or validation cohorts. Score modeling was conducted using a multivariate logistic regression model, and calibration of the model and score was assessed using the Hosmer-Lemeshow goodness-of-fit test and GiViTi Calibration belts. The model and generated score's discrimination capacity were analyzed by calculating the Area Under Curve (AUC). Results: The development cohort included 485 patients and the validation cohort included 341 patients. The scoring system was developed using four criteria as predictors of poor clinical control of COPD reported by the treating physician: adjusted dyspnea severity, use of rescue inhaler more than three times per week, walking less than 30 minutes per day, and COPD exacerbations in the last three months. The scoring system attributed scores from 0 to 8. Calibration was satisfactory in both development and validation cohorts, and the score’s discrimination power, as indicated by the AUC, was 0.892. Conclusions: This scoring system provides a quantitative assessment of clinical control in COPD.