PT -期刊文章盟Mohsen Sadatsafavi AU -詹姆斯·麦科马克盟-约翰Petkau AU -拉里·d·林德AU - Tae Yoon李盟不d罪TI -急性发作的数量在去年被用来指导治疗慢性阻塞性肺病?援助- 10.1183/13993003.02122 -2020 DP - 2021年2月01 TA -欧洲呼吸杂志》第六PG - 2002122 - 57 IP - 2 4099 - //www.qdcxjkg.com/content/57/2/2002122.short 4100 - //www.qdcxjkg.com/content/57/2/2002122.full所以欧元和J2021 2月01;57 AB -背景在当代管理的慢性阻塞性肺疾病(COPD),经常exacerbator表型,基于12个月历史的急性加重的慢性阻塞性肺病(AECOPD),是一个主要的决定因素的治疗建议。然而,有相当大的争论,随着时间的推移这种表型的稳定。方法我们使用基本原则的比较分析表明,变化频繁exacerbator表型有两个主要来源:可变性在底层AECOPD率和个人AECOPDs发生的随机性。我们从两大军团重新分析数据,评估慢性阻塞性肺病纵向识别预测替代终点(ECLIPSE)研究和亚种群和中间结果在慢性阻塞性肺病研究(SPIROMICS),使用贝叶斯模型,分离这些差异的来源。然后我们评估的稳定性经常exacerbator表型基于这些结果。结果在这两个军团,AECOPDs强烈支持的模式的存在的底层AECOPD细化率随时间是稳定的(贝叶斯因子小于0.001)。尽管如此,观察AECOPD率可以在个别病人同比明显不同。对于一个潜在的每年0.8 - -3.1事件·−1,频繁exacerbator分类,根据观察到的速度,变化超过30%的时间连续两年由于单独的机会。 This value increases to more than 45% for those with an underlying rate of 1.2–2.2 events·year−1.Conclusions While the underlying AECOPD rate is a stable trait, the frequent exacerbator phenotype based on observed AECOPD patterns is unstable, so much so that its suitability for informing treatment decisions should be questioned. Whether evaluating AECOPD history over longer durations or using multivariate prediction models can result in more stable phenotyping needs to be evaluated.Dichotomisation of COPD exacerbation frequencies based on observed number of events in the previous year results in phenotypes that are inherently unstable, so much so that their suitability for informing treatment decisions should be seriously questioned https://bit.ly/34nFClc