Centre of Expertise Urban Vitality

A simple algorithm for the identification of clinical COPD phenotypes


This study aimed to identify simple rules for allocating chronic obstructive pulmonary disease (COPD) patients to clinical phenotypes identified by cluster analyses. Data from 2409 COPD patients of French/Belgian COPD cohorts were analysed using cluster analysis resulting in the identification of subgroups, for which clinical relevance was determined by comparing 3-year all-cause mortality. Classification and regression trees (CARTs) were used to develop an algorithm for allocating patients to these subgroups. This algorithm was tested in 3651 patients from the COPD Cohorts Collaborative International Assessment (3CIA) initiative. Cluster analysis identified five subgroups of COPD patients with different clinical characteristics (especially regarding severity of respiratory disease and the presence of cardiovascular comorbidities and diabetes). The CART-based algorithm indicated that the variables relevant for patient grouping differed markedly between patients with isolated respiratory disease (FEV1, dyspnoea grade) and those with multi-morbidity (dyspnoea grade, age, FEV1 and body mass index). Application of this algorithm to the 3CIA cohorts confirmed that it identified subgroups of patients with different clinical characteristics, mortality rates (median, from 4% to 27%) and age at death (median, from 68 to 76 years). A simple algorithm, integrating respiratory characteristics and comorbidities, allowed the identification of clinically relevant COPD phenotypes.

Reference Burgel, P.-R., Paillasseur, J.-L., Janssens, W., Piquet, J., ter Riet, G., Garcia-Aymerich, J., Cosio, B., Bakke, P., Puhan, M. A., Langhammer, A., Alfageme, I., Almagro, P., Ancochea, J., Celli, B. R., Casanova, C., de-Torres, J. P., Decramer, M., Echazarreta, A., Esteban, C., ... Initiatives BPCO, EABPCO, Leuven and 3CIA study groups (2017). A simple algorithm for the identification of clinical COPD phenotypes. European Respiratory Journal, 50(5), 1-11. Article 1701034. https://doi.org/10.1183/13993003.01034-2017
Published by  Urban Vitality 1 November 2017

Publication date

Nov 2017


Pierre-Régis Burgel
Jean-Louis Paillasseur
Wim Janssens
Jacques Piquet
Judith Garcia-Aymerich
Borja Cosio
Per Bakke
Milo A. Puhan
Arnulf Langhammer
Inmaculada Alfageme
Pere Almagro
Julio Ancochea
Bartolome R. Celli
Ciro Casanova
Juan P. de-Torres
Marc Decramer
Andrés Echazarreta
Cristobal Esteban
Rosa Mar Gomez Punter
MeiLan K. Han
Ane Johannessen
Bernhard Kaiser
Bernd Lamprecht
Peter Lange
Linda Leivseth
Jose M. Marin
Francis Martin
Pablo Martinez-Camblor
Marc Miravitlles
Toru Oga
Ana Sofia Ramírez
Don D. Sin
Patricia Sobradillo
Juan J. Soler-Cataluña
Alice M. Turner
Francisco Javier Verdu Rivera
Joan B. Soriano
Nicolas Roche
Initiatives BPCO, EABPCO, Leuven and 3CIA study groups
Initiatives BPCO, EABPCO, Leuven and 3CIA study groups

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