Jones et al reported the DOSE index for patients with chronic obstructive pulmonary disease (COPD). This can help to identify a patient with more severe disease who may benefit from more aggressive management or who may use more health resources. The authors are from the University of Plymouth, University College London, Leiden University Medical Center, Nippon Medical School (Tokyo) and the University of Aberdeen.
Patient selection: COPD
Parameters:
(1) MRC dyspnea scale score (D)
(2) obstruction (O) based on FEV1 as percent of predicted
(3) current smoking status (S)
(4) exacerbations per year (E)
Parameter
Finding
Points
MRC dyspnea scale score
0 or 1
0
2
1
3
2
4
3
FEV1 as percent of predicted
>= 50%
0
30 to 49%
1
< 30%
2
current smoking status
nonsmoker
0
smoker
1
exacerbations
0 to 1
0
2 or 3
1
>= 4
2
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the more severe the COPD.
• A score >= 4 is associated with a greater risk of hospital admission or respiratory failure.
Performance:
• The area under the ROC curve was 0.76.
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