title: The ADO index as a predictor of two-year mortality in general practice-based chronic obstructive pulmonary disease cohorts.
abstract: BACKGROUND
  Existing 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.
  
  
  OBJECTIVE
  Our 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.
  
  
  METHODS
  Six 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.
  
  
  RESULTS
  Fifty-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).
  
  
  CONCLUSIONS
  The ADO index showed excellent prediction properties in an out-of-population validation carried out in COPD patients from primary care settings.
authors.affiliation: University Clinic of Internal Medicine, Kantonsspital Baselland, Basel, Switzerland.
authors.forename: Nebal
authors.initials: N
authors.lastname: Abu Hussein
authors.forename: Gerben
authors.initials: G
authors.lastname: Ter Riet
authors.forename: Lucia
authors.initials: L
authors.lastname: Schoenenberger
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Bridevaux
authors.forename: Prashant N
authors.initials: PN
authors.lastname: Chhajed
authors.forename: Jean-William
authors.initials: JW
authors.lastname: Fitting
authors.forename: Thomas
authors.initials: T
authors.lastname: Geiser
authors.forename: Anja
authors.initials: A
authors.lastname: Jochmann
authors.forename: Ladina
authors.initials: L
authors.lastname: Joos Zellweger
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.forename: Sabrina
authors.initials: S
authors.lastname: Maier
authors.forename: David
authors.initials: D
authors.lastname: Miedinger
authors.forename: Salome
authors.initials: S
authors.lastname: Schafroth Török
authors.forename: Andreas
authors.initials: A
authors.lastname: Scherr
authors.forename: Lara
authors.initials: L
authors.lastname: Siebeling
authors.forename: Robert
authors.initials: R
authors.lastname: Thurnheer
authors.forename: Michael
authors.initials: M
authors.lastname: Tamm
authors.forename: Milo A
authors.initials: MA
authors.lastname: Puhan
authors.forename: Joerg Daniel
authors.initials: JD
authors.lastname: Leuppi
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D011320:Primary Health Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D018570:Risk Assessment / Q000379:methods; D013557:Switzerland