User login
Credit: CDC
A scoring system that rates symptoms of pulmonary dysfunction can help predict survival in patients with chronic graft-vs-host disease (GVHD), new research suggests.
The National Institutes of Health (NIH) devised a scoring system whereby patients can rate their breathing difficulties on a scale of 0 to 3.
In a study of nearly 500 patients with chronic GVHD, this system proved more effective in predicting survival than other measures of pulmonary dysfunction.
A patient’s score was significantly associated with the risk of overall survival (OS) and non-relapse mortality (NRM).
Stephanie Lee, MD, MPH, of the Fred Hutchinson Cancer Research Center in Seattle, and her colleagues reported these findings in Biology of Blood and Marrow Transplantation.
The researchers evaluated the utility of pulmonary function tests (PFTs) and symptom assessment in predicting the outcomes of 496 patients with chronic GVHD. The team looked at results of PFTs and the NIH lung scoring system, which has 2 parts.
One part is the NIH symptom-based lung score, which assigns the following numbers to breathing difficulties: 0 for no symptoms, 1 for shortness of breath climbing stairs, 2 for shortness of breath on flat ground, and 3 for shortness of breath at rest or requiring oxygen.
The second part of the system is the NIH PFT-based lung score, a lung function score calculated according to a patient’s forced expiratory volume in 1 second (FEV1) and diffusing capacity of carbon monoxide (DLCO), corrected for hemoglobin but not alveolar volume.
The researchers focused on a set of hypothesized associations between pulmonary measures and NRM, OS, patient-reported outcomes, and functional status.
The 7 measures of interest were:
- Obstructive lung disease based on PFTs
- Restrictive lung disease based on PFTs
- NIH PFT-based lung score
- NIH symptom-based lung score
- Clinical diagnosis of bronchiolitis obliterans syndrome
- Decrease in FEV1 or forced vital capacity (FVC) compared to enrollment
- Worsening of NIH symptom-based lung score by 1 point or greater compared with the first recorded score.
The researchers found that only the NIH symptom-based lung score was significantly associated with NRM (P=0.02), OS (P=0.02), patient-reported symptoms (P<0.001), and functional status (P<0.001).
In addition, worsening of the NIH symptom-based lung score over time was associated with higher NRM and lower OS.
None of the other measures studied were significantly associated with OS or NRM, although some were associated with patient-reported symptoms.
“The [NIH symptom-based lung score] turned out to be the most predictive,” Dr Lee said. “It’s just a question [and], therefore, easy to do and cost-effective. No special equipment is involved.”
This suggests there’s a simple way for physicians to detect pulmonary dysfunction earlier, she added. A patient’s doctor could follow up on a poor score with tests to determine the cause of the problem and identify the appropriate treatment. 
Credit: CDC
A scoring system that rates symptoms of pulmonary dysfunction can help predict survival in patients with chronic graft-vs-host disease (GVHD), new research suggests.
The National Institutes of Health (NIH) devised a scoring system whereby patients can rate their breathing difficulties on a scale of 0 to 3.
In a study of nearly 500 patients with chronic GVHD, this system proved more effective in predicting survival than other measures of pulmonary dysfunction.
A patient’s score was significantly associated with the risk of overall survival (OS) and non-relapse mortality (NRM).
Stephanie Lee, MD, MPH, of the Fred Hutchinson Cancer Research Center in Seattle, and her colleagues reported these findings in Biology of Blood and Marrow Transplantation.
The researchers evaluated the utility of pulmonary function tests (PFTs) and symptom assessment in predicting the outcomes of 496 patients with chronic GVHD. The team looked at results of PFTs and the NIH lung scoring system, which has 2 parts.
One part is the NIH symptom-based lung score, which assigns the following numbers to breathing difficulties: 0 for no symptoms, 1 for shortness of breath climbing stairs, 2 for shortness of breath on flat ground, and 3 for shortness of breath at rest or requiring oxygen.
The second part of the system is the NIH PFT-based lung score, a lung function score calculated according to a patient’s forced expiratory volume in 1 second (FEV1) and diffusing capacity of carbon monoxide (DLCO), corrected for hemoglobin but not alveolar volume.
The researchers focused on a set of hypothesized associations between pulmonary measures and NRM, OS, patient-reported outcomes, and functional status.
The 7 measures of interest were:
- Obstructive lung disease based on PFTs
- Restrictive lung disease based on PFTs
- NIH PFT-based lung score
- NIH symptom-based lung score
- Clinical diagnosis of bronchiolitis obliterans syndrome
- Decrease in FEV1 or forced vital capacity (FVC) compared to enrollment
- Worsening of NIH symptom-based lung score by 1 point or greater compared with the first recorded score.
The researchers found that only the NIH symptom-based lung score was significantly associated with NRM (P=0.02), OS (P=0.02), patient-reported symptoms (P<0.001), and functional status (P<0.001).
In addition, worsening of the NIH symptom-based lung score over time was associated with higher NRM and lower OS.
None of the other measures studied were significantly associated with OS or NRM, although some were associated with patient-reported symptoms.
“The [NIH symptom-based lung score] turned out to be the most predictive,” Dr Lee said. “It’s just a question [and], therefore, easy to do and cost-effective. No special equipment is involved.”
This suggests there’s a simple way for physicians to detect pulmonary dysfunction earlier, she added. A patient’s doctor could follow up on a poor score with tests to determine the cause of the problem and identify the appropriate treatment.
Credit: CDC
A scoring system that rates symptoms of pulmonary dysfunction can help predict survival in patients with chronic graft-vs-host disease (GVHD), new research suggests.
The National Institutes of Health (NIH) devised a scoring system whereby patients can rate their breathing difficulties on a scale of 0 to 3.
In a study of nearly 500 patients with chronic GVHD, this system proved more effective in predicting survival than other measures of pulmonary dysfunction.
A patient’s score was significantly associated with the risk of overall survival (OS) and non-relapse mortality (NRM).
Stephanie Lee, MD, MPH, of the Fred Hutchinson Cancer Research Center in Seattle, and her colleagues reported these findings in Biology of Blood and Marrow Transplantation.
The researchers evaluated the utility of pulmonary function tests (PFTs) and symptom assessment in predicting the outcomes of 496 patients with chronic GVHD. The team looked at results of PFTs and the NIH lung scoring system, which has 2 parts.
One part is the NIH symptom-based lung score, which assigns the following numbers to breathing difficulties: 0 for no symptoms, 1 for shortness of breath climbing stairs, 2 for shortness of breath on flat ground, and 3 for shortness of breath at rest or requiring oxygen.
The second part of the system is the NIH PFT-based lung score, a lung function score calculated according to a patient’s forced expiratory volume in 1 second (FEV1) and diffusing capacity of carbon monoxide (DLCO), corrected for hemoglobin but not alveolar volume.
The researchers focused on a set of hypothesized associations between pulmonary measures and NRM, OS, patient-reported outcomes, and functional status.
The 7 measures of interest were:
- Obstructive lung disease based on PFTs
- Restrictive lung disease based on PFTs
- NIH PFT-based lung score
- NIH symptom-based lung score
- Clinical diagnosis of bronchiolitis obliterans syndrome
- Decrease in FEV1 or forced vital capacity (FVC) compared to enrollment
- Worsening of NIH symptom-based lung score by 1 point or greater compared with the first recorded score.
The researchers found that only the NIH symptom-based lung score was significantly associated with NRM (P=0.02), OS (P=0.02), patient-reported symptoms (P<0.001), and functional status (P<0.001).
In addition, worsening of the NIH symptom-based lung score over time was associated with higher NRM and lower OS.
None of the other measures studied were significantly associated with OS or NRM, although some were associated with patient-reported symptoms.
“The [NIH symptom-based lung score] turned out to be the most predictive,” Dr Lee said. “It’s just a question [and], therefore, easy to do and cost-effective. No special equipment is involved.”
This suggests there’s a simple way for physicians to detect pulmonary dysfunction earlier, she added. A patient’s doctor could follow up on a poor score with tests to determine the cause of the problem and identify the appropriate treatment.