C-Reactive Protein for Antibiotic Use in COPD Exacerbations.
(2019) The New England journal of medicine — Vol. 381, n° 24, p. 2371-2372 (2019)
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- Abstract
- Butler et al. used the Clinical COPD Questionnaire (CCQ) but did not use the COPD Assessment Test (CAT). CAT test results would be of interest, since a CAT score of 10 or higher indicates an increased risk of exacerbation in patients with COPD, whereas there is no indicator for increased risk of exacerbation in the CCQ.1 Moreover, the 2018 and 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend the CAT as one component of the grading of symptom burden and as a means of categorizing patients into one of four groups according to severity of symptoms (A through D, with group A having the least severe symptoms and group D the most severe),2 all of which leads to the question of whether there was selection bias in the trial. The inclusion of patients with low CAT scores or those in GOLD group A or B would make it difficult to extrapolate the results of the trial to all patients.
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Citations
Yildiz, H. (2019). C-Reactive Protein for Antibiotic Use in COPD Exacerbations. The New England journal of medicine, 381(24), 2371-2372. https://doi.org/10.1056/NEJMc1912624 (Original work published 2019)