Publications
265 results found
Quint JK, Donaldson GC, Hurst JR, et al., 2011, Predictive accuracy of patient-reported exacerbation frequency in COPD, Eur Respir J, Vol: 37, Pages: 501-507, ISSN: 1399-3003
Chronic obstructive pulmonary disease (COPD) exacerbation frequency is important for clinical risk assessment and trial recruitment. In order to accurately establish exacerbation frequency, patients need to be followed for 1 yr, although this is not always practical. 1) Patient recall of exacerbation number during the year prior to recruitment to the London COPD cohort was compared with the number of exacerbations recorded on diary cards during the subsequent year; and 2) patient recall of their exacerbation number after 1 yr of follow-up was compared with documented exacerbations over the same year. A total of 267 patients (forced expiratory volume in 1 s 1.14 L) recorded worsening of respiratory symptoms on daily diary cards for 1 yr. Exacerbations were defined according to previously validated criteria. There was no difference between the exacerbation number recalled by patients prior to recruitment and the number detected during the first year (median 2.0 (interquartile range 1.0-4.0) and 2.0 (1.0-4.0); expected agreement 76.4%; agreement 84.6%; kappa = 0.3469). There was no difference between the number of exacerbations remembered by patients and the number recorded on diary cards over the same 1-yr period (2.0 (1.0-4.0) for both groups; expected agreement 74.9%; actual agreement 93.3%; kappa = 0.6146). Patients remember the number of exacerbations they have in a year. Accuracy is increased when comparing the same 1-yr period. Patient recall is sufficiently robust for stratification into frequent and infrequent exacerbator groups for subsequent years.
Hurst JR, Vestbo J, Wedzicha JA, 2010, Susceptibility to Exacerbation in COPD REPLY, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 363, Pages: 2671-2671, ISSN: 0028-4793
Hurst JR, Donaldson GC, Quint JK, et al., 2010, Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study, BMC Pulmonary Medicine, Vol: 10, ISSN: 1471-2466
Hurst JR, Vestbo J, Anzueto A, et al., 2010, Susceptibility to Exacerbation in Chronic Obstructive Pulmonary Disease., NEW ENGLAND JOURNAL OF MEDICINE, Vol: 363, Pages: 1128-1138, ISSN: 0028-4793
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- Citations: 1967
Wedzicha JA, Johnston SL, 2010, <i>Thorax</i> 2010: celebrating the success of an international respiratory journal, THORAX, Vol: 65, Pages: 755-756, ISSN: 0040-6376
Taylor AE, Finney-Hayward TK, Quint JK, et al., 2010, Defective macrophage phagocytosis of bacteria in COPD, EUROPEAN RESPIRATORY JOURNAL, Vol: 35, Pages: 1039-1047, ISSN: 0903-1936
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- Citations: 251
Wedzicha JA, Johnston SL, 2009, Thorax 2009: another great year!, THORAX, Vol: 64, Pages: 1017-1018, ISSN: 0040-6376
Thomas CMR, Saunders MA, Wedzicha JA, et al., 2009, DECREASED MACROPHAGE FUNCTION IN COPD, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A55-A56, ISSN: 0040-6376
Hurst JR, Wedzicha JA, 2009, Management and prevention of chronic obstructive pulmonary disease exacerbations: a state of the art review, BMC MEDICINE, Vol: 7, ISSN: 1741-7015
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- Citations: 33
Seemungal TAR, Wedzicha JA, 2009, Acute exacerbations of COPD: The Challenge is Early Treatment, COPD-JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, Vol: 6, Pages: 79-81, ISSN: 1541-2555
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- Citations: 15
Baghai-Ravary R, Quint JK, Goldring JJP, et al., 2009, Determinants and impact of fatigue in patients with chronic obstructive pulmonary disease, RESPIRATORY MEDICINE, Vol: 103, Pages: 216-223, ISSN: 0954-6111
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- Citations: 85
Wedzicha JA, Calverley PMA, Seemungal TA, et al., 2009, The INSPIRE Trial Results: Are They Truly Breathtaking?, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 179, Pages: 80-81, ISSN: 1073-449X
Kon OM, Hansel TT, Barnes PJ, 2009, Chronic Obstructive Pulmonary Disease (COPD), Publisher: Oxford University Press, ISBN: 9780199549146
This compact volume of the Oxford Respiratory Medicine Library summarizes up-to-date literature in a style that will have direct clinical application to busy health care professionals.
Taylor AE, Quint J, Wedzicha JA, et al., 2009, Microtubule Instability in COPD Leads to Defective Macrophage Phagocytosis of Bacteria, Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Donaldson G, Seemungal TAR, Patel IS, et al., 2009, Airway and systemic inflammation and decline in lung function in patients with COPD. 2005, Chest
Jones RC, Donaldson GC, Chavannes NH, et al., 2009, Derivation and validation of a composite index of severity in chronic obstructive pulmonary disease: the DOSE Index, Am J Respir Crit Care Med, Vol: 180, Pages: 1189-1195, ISSN: 1535-4970
Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a multicomponent disease with systemic consequences and effects on quality of life. Single measures such as lung function provide a limited reflection of how the disease affects patients. Composite measures have the potential to account for many of the facets of COPD.
Hurst JR, Donaldson GC, Quint JK, et al., 2009, Temporal Clustering of Exacerbations in Chronic Obstructive Pulmonary Disease, AM J RESP CRIT CARE, Vol: 179, Pages: 369-374, ISSN: 1073-449X
Rationale: Exacerbations are important events in chronic obstructive pulmonary disease. Preventing exacerbations is a key treatment goal. Observational data suggest that after a first exacerbation, patients may be at increased risk of a second exacerbation, but this has not been specifically studied. We hypothesized that exacerbations may cluster together in time, a finding that would have important implications for targeting preventative interventions and the analysis of clinical trial data.Objectives: To assess whether exacerbations are random events, or cluster in time.Methods: A total of 297 patients in the London chronic obstructive pulmonary disease cohort recorded daily symptoms and were assessed for a total of 904 patient-years. The observed timing of second exacerbations after an initial exacerbation was compared with that expected should exacerbations occur randomly.Measurements and Main Results: The observed timing distribution of second exacerbations differed significantly (P < 0.001) from the expected exponential function (shape parameter of the fitted Weibull function, 0.966 [95% confidence interval, 0.948-0.985]), suggesting that more second exacerbations occurred sooner than later and that exacerbations cluster together in time. Twenty-seven percent of first exacerbations were followed by a second recurrent event within 8 weeks. Approximately one third of exacerbations were recurrent exacerbations. Although initial exacerbations were milder than isolated events, they were not less likely to receive treatment, and under-treatment of initial events is not a plausible explanation for exacerbation recurrence. Recurrent exacerbations contribute significantly to overall exacerbation frequency (rho 0.81; P < 0.0001).Conclusions: Exacerbations are not random events but cluster together in time such that there is a high-risk period for recurrent exacerbation in the 8-week period after an initial excerbation.
Quint JK, Wedzicha JA, 2009, Role of respiratory viral infection at exacerbation., Chronic Obstructive Pulmonary Disease Exacerbations, Publisher: Informa Healthcare USA
Seemungal TAR, Hurst JR, Wedzicha JA, 2009, Exacerbation rate, health status and mortality in COPD--a review of potential interventions., Int J Chron Obstruct Pulmon Dis, Vol: 4, Pages: 203-223
COPD is prevalent in Western society and its incidence is rising in the developing world. Acute exacerbations of COPD, about 50% of which are unreported, lead to deterioration in quality of life and contribute significantly to disease burden. Quality of life deteriorates with time; thus, most of the health burden occurs in more severe disease. COPD severity and frequent and more severe exacerbations are all related to an increased risk of mortality. Inhaled corticosteroids (ICS) have similar effects on quality of life but ICS/long-acting bronchodilator combinations and the long-acting antimuscarinic tiotropium all improve health status and exacerbation rates and are likely to have an effect on mortality but perhaps only with prolonged use. Erythromycin has been shown to decrease the rate of COPD exacerbations. Pulmonary rehabilitation and regular physical activity are indicated in all severities of COPD and improve quality of life. Noninvasive ventilation is associated with improved quality of life. Long-term oxygen therapy improves mortality but only in hypoxic COPD patients. The choice of an inhaler device is a key component of COPD therapy and this requires more attention from physicians than perhaps we are aware of. Disease management programs, characterized as they are by patient centeredness, improve quality of life and decrease hospitalization rates. Most outcomes in COPD can be modified by interventions and these are well tolerated and have acceptable safety profiles.
Wedzicha JA, Johnston SL, 2008, Thorax update: October 2007-September 2008, THORAX, Vol: 63, Pages: 1036-1037, ISSN: 0040-6376
Donaldson GC, Esmond G, Balfour-Lynn I, et al., 2008, DEPRIVATION, RURALITY AND THE USE OF HOME OXYGEN IN ENGLAND AND WALES, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A75-A75, ISSN: 0040-6376
Sikkel MB, Quint JK, Mallia P, et al., 2008, Respiratory syncytial virus persistence in chronic obstructive pulmonary disease, PEDIATRIC INFECTIOUS DISEASE JOURNAL, Vol: 27, Pages: S63-S70, ISSN: 0891-3668
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- Citations: 77
Cazzola M, MacNee W, Martinez FJ, et al., 2008, Outcomes for COPD pharmacological trials:: from lung function to biomarkers, EUROPEAN RESPIRATORY JOURNAL, Vol: 31, Pages: 416-468, ISSN: 0903-1936
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- Citations: 643
Donaldson GC, Edmonds G, Balfour-Lynn I, et al., 2007, Development of the British thoracic society home oxygen database and prevalence of home oxygen use in England and wales, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A64-A64, ISSN: 0040-6376
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- Citations: 3
RESTRICK LJ, SCOTT AD, WARD EM, et al., 1993, NASAL INTERMITTENT POSITIVE-PRESSURE VENTILATION IN WEANING INTUBATED PATIENTS WITH CHRONIC RESPIRATORY-DISEASE FROM ASSISTED INTERMITTENT, POSITIVE-PRESSURE VENTILATION, RESPIRATORY MEDICINE, Vol: 87, Pages: 199-204, ISSN: 0954-6111
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- Citations: 58
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