JHSPH LogoScientists at the Johns Hopkins Bloomberg School of Public Health have developed an index scale in order to assist physicians to predict a patient’s possibility of dying from chronic obstructive pulmonary disease (COPD). With the help of the ADO index physicians may perhaps be able to evaluate the seriousness of a patient’s illness in order to determine the suitable level of treatment.

COPD is known to comprise of emphysema and chronic bronchitis. Also, it is believed to be a major public health problem and is claimed to be the fourth leading cause of death in the U.S.

It was estimated that COPD affects more than 16 million Americans. Additionally, it seems to be the only disease among the top 10 causes of death with an increasing mortality rate in the United States. Evidently, it is predicted to be the third largest cause of death by 2020 and has supposedly reached global epidemic proportions already.

Apparently, at present, the BODE index is utilized by chest physicians in order to estimate a patient’s risk of death from COPD. The index appears to be based on an assessment of body-mass index, airflow obstruction, exercise capacity and dyspnea.

However, the BODE index seems to be rarely used in primary care settings because exercise capacity cannot be easily measured inside the standard doctor’s office. Supposedly, a primary care setting is where most patient treatment options are controlled.

Lead author of the study, Milo A. Puhan, MD, PhD, associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, stated that, “The burden from COPD is so enormous that we need to reach out to any doctors who care for COPD patients. The ADO index can be used in any setting and we hope that it will serve as a basis for more individualized treatment selection in the near future.”

For the purpose of the study, Puhan along with his colleagues developed a simplified BODE index and the ADO index. These indices were noted to include age, dyspnea and airflow obstruction.

It was observed that the team compared the predictions of the BODE index with the 3-year risk of all-cause mortality from nearly 232 COPD patients from Switzerland. The updated BODE index and the novel ADO index was then validated with a group of about 342 COPD patients from Spain.

The findings of the study revealed that the updated BODE and ADO indices seem to have exactly predicted 3-year mortality. They also appear to have matched the observed mortality in the Spanish group. However, there seemed to be a little difference between predicted and observed mortality in contrast to the original BODE index, which performed badly at predicting a 3-year risk of mortality.

Furthermore, the analysis of the BODE index appears to have shown a 36 percent relative under prediction in the Swiss group and a 39 percent relative over prediction in the Spanish group.

The findings of the study have been published in the journal, The Lancet.