• Nebal Abu Hussein, Gerben Ter Riet, Lucia Schoenenberger, Pierre-Olivier Bridevaux, Prashant N Chhajed, Jean-William Fitting, Thomas Geiser, Anja Jochmann, Ladina Joos Zellweger, Malcolm Kohler, Sabrina Maier, David Miedinger, Salome Schafroth Török, Andreas Scherr, Lara Siebeling, Robert Thurnheer, Michael Tamm, Milo A Puhan, and Joerg Daniel Leuppi.
• University Clinic of Internal Medicine, Kantonsspital Baselland, Basel, Switzerland.
• Respiration. 2014 Jan 1;88(3):208-14.

BackgroundExisting prediction models for mortality in chronic obstructive pulmonary disease (COPD) patients have not yet been validated in primary care, which is where the majority of patients receive care.ObjectivesOur aim was to validate the ADO (age, dyspnoea, airflow obstruction) index as a predictor of 2-year mortality in 2 general practice-based COPD cohorts.MethodsSix hundred and forty-six patients with COPD with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I-IV were enrolled by their general practitioners and followed for 2 years. The ADO regression equation was used to predict a 2-year risk of all-cause mortality in each patient and this risk was compared with the observed 2-year mortality. Discrimination and calibration were assessed as well as the strength of association between the 15-point ADO score and the observed 2-year all-cause mortality.ResultsFifty-two (8.1%) patients died during the 2-year follow-up period. Discrimination with the ADO index was excellent with an area under the curve of 0.78 [95% confidence interval (CI) 0.71-0.84]. Overall, the predicted and observed risks matched well and visual inspection revealed no important differences between them across 10 risk classes (p = 0.68). The odds ratio for death per point increase according to the ADO index was 1.50 (95% CI 1.31-1.71).ConclusionsThe ADO index showed excellent prediction properties in an out-of-population validation carried out in COPD patients from primary care settings.

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