COPD: A Catch-up Quiz

Recent chronic obstructive pulmonary disease (COPD) research describes the consequences of a late diagnosis, patient characteristics associated with exacerbations, a new test to stratify mortality risk, and other important findings. Take this brief test to find out what you know about the latest developments in COPD patient care.

1. Which of the following are clinical consequences of a late COPD diagnosis?

A. Higher exacerbation rate
B. Shorter time to first exacerbation
C. Greater mortality
D. All of the above
E. A and B

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Answer: D. All of the above. In a recent study of Swedish primary care patients, the exacerbation rate was higher, the time to first exacerbation was shorter, and mortality was greater in those with a late COPD diagnosis vs early diagnosis. Also, 22% of patients with a late diagnosis had a recent comorbid diagnosis of asthma vs 3.9% of those with an early diagnosis; late diagnosis also resulted in higher direct costs.

2. In a recent study, the risk of first moderate or severe exacerbation was greater in which patients who had a new diagnosis of COPD?

A. Men
B. Women
C. Patients aged ≥65 years
D. Patients in GOLD 2016 group A

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Answer: B. Women. According to a recent retrospective cohort study, the risk of first moderate or severe exacerbation was 17% greater in women vs men and the median time to first exacerbation was 504 days for women vs 637 days for men. These differences were greater among women who were younger; in GOLD 2016 groups B, C, and D; and had moderate-to-severe airflow obstruction.

3. A new prediction model for patients with COPD, the Laboratory-based Intermountain Validated Exacerbation (LIVE) score, is based on which of the following tests?

A. Spirometry
B. Chest CT scan
C. Blood tests
D. Urine tests

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Answer: C. Blood tests. The LIVE score, based entirely on blood tests, predicts all-cause mortality, morbidity, and hospitalization rates for patients with COPD by combining simple laboratory values to identify those who are at high risk for death or disease advancement and may need referrals to palliative care.

4. In a study of hospital outpatients with COPD, misuse of inhalation devices resulting from critical errors was NOT positively related to which of the following?

A. Patients’ clinical or functional characteristics
B. Female sex
C. Age ≥65 years
D. Lower education level

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Answer: A. Patients’ clinical or functional characteristics. Failure of inhalation maneuver was the main cause of inhaler misuse in a cross-sectional study with at least 1 step performed incorrectly in 48.2% of patient demonstrations and critical errors seen in 29.9%. Misuse resulting from critical errors was positively related to lower socioeconomic status as well as female sex, age ≥65 years, and lower education level.

5. Which statement/s best describes the association between COPD and higher median baseline Pittsburgh Sleep Quality Index (PSQI) scores?

A. Increased risk of COPD exacerbation
B. Decreased risk of COPD exacerbation
C. Shorter time to symptom-based exacerbation
D. Longer time to symptom-based exacerbation
E. A and C
F. B and D

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Answer: E. A and C. In a recent study, patients with COPD who had subsequent symptom-based exacerbations were more likely to have a baseline PSQI score >5. Higher PSQI scores were linked with increased risk of symptom- and event-based exacerbations (mainly in patients with undiagnosed COPD) and a shorter amount of time to symptom-based exacerbation.

For more information on all questions and answers, please visit COPD Insights: 8 Studies in Brief.

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