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1.
Tumour Biol ; 42(2): 1010428320907544, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32098581

RESUMO

Cancer researchers require accurate diagnoses for the samples, cell lines, patients or populations that they study. These diagnoses are underpinned by an internationally accepted taxonomy - the World Health Organization Classification of Tumours. This is still largely based on the histopathological examination of biopsy specimens, but increasingly also molecular methods and radiological examination of patients. Classifications evolve as new evidence arises, and for tumours that evidence is available in a quantity that is both remarkable and daunting. Evaluating this deluge of new information and incorporating it into the World Health Organization Classification of Tumours is now the responsibility of an editorial board, and up to 200 editors and authors work on each system to update it within the new 5th edition. Just as cancer researchers depend on the classification for diagnoses, so too the classification depends on the generation of high-quality, trustworthy data by cancer researchers. It is not just a case of quantity but quality too. Scientific fraud is thankfully rare, but high-profile cases are damaging and standards need to improve, not least to ensure that accurate information enters the classification.


Assuntos
Classificação/métodos , Neoplasias/diagnóstico , Humanos , Neoplasias/classificação , Neoplasias/epidemiologia , Pesquisadores , Organização Mundial da Saúde
2.
Arch Virol ; 165(2): 519-525, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31797129

RESUMO

The Executive Committee of the International Committee on Taxonomy of Viruses (ICTV) recognizes the need for a standardized nomenclature for virus species. This article sets out the case for establishing a binomial nomenclature and presents the advantages and disadvantages of different naming formats. The Executive Committee understands that adopting a binomial system would have major practical consequences, and invites comments from the virology community before making any decisions to change the existing nomenclature. The Executive Committee will take account of these comments in deciding whether to approve a standardized binomial system at its next meeting in October 2020. Note that this system would relate only to the formal names of virus species and not to the names of viruses.


Assuntos
Classificação/métodos , Terminologia como Assunto , Vírus/classificação
3.
Integr Zool ; 15(1): 2-15, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30983164

RESUMO

The use of the "integrative approach" for classification of organisms since its formal establishment in 2005 has become a recurrent theme of zoosystematics. A bibliometric survey of the publications on integrative taxonomy of animals, which is aimed at exploring the most popular areas of research and characterizing the practical systematists' attitudes to this new approach, is presented. An analysis of 582 papers, which appeared between 2005 and 2017 in journals indexed by Scopus and the Web of Science Core Collection, has illustrated the gradual growth of the popularity of integrative taxonomy as well as some biases in the representation of higher taxa in "integrated" studies. It has been shown that the "integrative" papers have more chance of appearing in a top-ranking journal and gain relatively more citations as compared with non-integrative papers. The obtained results are discussed in the context of the "taxonomic impediment" problem thought to be a consequence of the institutional crisis of traditional taxonomy, which has been vividly debated over the past decades.


Assuntos
Biodiversidade , Classificação/métodos , Animais
4.
Syst Biol ; 69(1): 124-138, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31127936

RESUMO

Timescales are of fundamental importance to evolutionary biology as they facilitate hypothesis tests of historical evolutionary processes. Through the incorporation of fossil occurrence data, the fossilized birth-death (FBD) process provides a framework for estimating divergence times using more paleontological data than traditional node calibration approaches have allowed. The inclusion of more data can refine evolutionary timescale estimates, but for many taxonomic groups it is computationally infeasible to include all available fossil occurrence data. Here, we utilize both empirical data and a simulation framework to identify approaches to subsampling fossil occurrence data that result in the most accurate estimates of divergence times. To achieve this we assess the performance of the FBD-Skyline model when implementing multiple approaches to incorporating subsampled fossil occurrence data. Our results demonstrate that it is necessary to account for all available fossil occurrence data to achieve the most accurate estimates of clade age. We show that this can be achieved if an empirical Bayes approach, accounting for fossil sampling through time, is applied to the FBD process. Random subsampling of occurrence data can lead to estimates of clade age that are incompatible with fossil evidence if no control over the affinities of fossil occurrences is enforced. Our results call into question the accuracy of previous divergence time studies incorporating the FBD process that have used only a subsample of all available fossil occurrence data.


Assuntos
Evolução Biológica , Classificação/métodos , Fósseis , Modelos Biológicos
5.
Syst Biol ; 69(1): 1-16, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31058981

RESUMO

Establishing an accurate evolutionary timescale for green plants (Viridiplantae) is essential to understanding their interaction and coevolution with the Earth's climate and the many organisms that rely on green plants. Despite being the focus of numerous studies, the timing of the origin of green plants and the divergence of major clades within this group remain highly controversial. Here, we infer the evolutionary timescale of green plants by analyzing 81 protein-coding genes from 99 chloroplast genomes, using a core set of 21 fossil calibrations. We test the sensitivity of our divergence-time estimates to various components of Bayesian molecular dating, including the tree topology, clock models, clock-partitioning schemes, rate priors, and fossil calibrations. We find that the choice of clock model affects date estimation and that the independent-rates model provides a better fit to the data than the autocorrelated-rates model. Varying the rate prior and tree topology had little impact on age estimates, with far greater differences observed among calibration choices and clock-partitioning schemes. Our analyses yield date estimates ranging from the Paleoproterozoic to Mesoproterozoic for crown-group green plants, and from the Ediacaran to Middle Ordovician for crown-group land plants. We present divergence-time estimates of the major groups of green plants that take into account various sources of uncertainty. Our proposed timeline lays the foundation for further investigations into how green plants shaped the global climate and ecosystems, and how embryophytes became dominant in terrestrial environments.


Assuntos
Evolução Biológica , Classificação/métodos , Fósseis , Viridiplantae/classificação , Genoma de Cloroplastos/genética , Tempo , Viridiplantae/genética
6.
Syst Biol ; 69(1): 17-37, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31062852

RESUMO

Resolving deep divergences in the tree of life is challenging even for analyses of genome-scale phylogenetic data sets. Relationships between Basidiomycota subphyla, the rusts and allies (Pucciniomycotina), smuts and allies (Ustilaginomycotina), and mushroom-forming fungi and allies (Agaricomycotina) were found particularly recalcitrant both to traditional multigene and genome-scale phylogenetics. Here, we address basal Basidiomycota relationships using concatenated and gene tree-based analyses of various phylogenomic data sets to examine the contribution of several potential sources of bias. We evaluate the contribution of biological causes (hard polytomy, incomplete lineage sorting) versus unmodeled evolutionary processes and factors that exacerbate their effects (e.g., fast-evolving sites and long-branch taxa) to inferences of basal Basidiomycota relationships. Bayesian Markov Chain Monte Carlo and likelihood mapping analyses reject the hard polytomy with confidence. In concatenated analyses, fast-evolving sites and oversimplified models of amino acid substitution favored the grouping of smuts with mushroom-forming fungi, often leading to maximal bootstrap support in both concatenation and coalescent analyses. On the contrary, the most conserved data subsets grouped rusts and allies with mushroom-forming fungi, although this relationship proved labile, sensitive to model choice, to different data subsets and to missing data. Excluding putative long-branch taxa, genes with high proportions of missing data and/or with strong signal failed to reveal a consistent trend toward one or the other topology, suggesting that additional sources of conflict are at play. While concatenated analyses yielded strong but conflicting support, individual gene trees mostly provided poor support for any resolution of rusts, smuts, and mushroom-forming fungi, suggesting that the true Basidiomycota tree might be in a part of tree space that is difficult to access using both concatenation and gene tree-based approaches. Inference-based assessments of absolute model fit strongly reject best-fit models for the vast majority of genes, indicating a poor fit of even the most commonly used models. While this is consistent with previous assessments of site-homogenous models of amino acid evolution, this does not appear to be the sole source of confounding signal. Our analyses suggest that topologies uniting smuts with mushroom-forming fungi can arise as a result of inappropriate modeling of amino acid sites that might be prone to systematic bias. We speculate that improved models of sequence evolution could shed more light on basal splits in the Basidiomycota, which, for now, remain unresolved despite the use of whole genome data.


Assuntos
Basidiomycota/classificação , Classificação/métodos , Modelos Genéticos , Filogenia , Basidiomycota/genética , Genes Fúngicos/genética
7.
Syst Biol ; 69(1): 194-207, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31086978

RESUMO

Despite the ubiquitous use of statistical models for phylogenomic and population genomic inferences, this model-based rigor is rarely applied to post hoc comparison of trees. In a recent study, Garba et al. derived new methods for measuring the distance between two gene trees computed as the difference in their site pattern probability distributions. Unlike traditional metrics that compare trees solely in terms of geometry, these measures consider gene trees and associated parameters as probabilistic models that can be compared using standard information theoretic approaches. Consequently, probabilistic measures of phylogenetic tree distance can be far more informative than simply comparisons of topology and/or branch lengths alone. However, in their current form, these distance measures are not suitable for the comparison of species tree models in the presence of gene tree heterogeneity. Here, we demonstrate an approach for how the theory of Garba et al. (2018), which is based on gene tree distances, can be extended naturally to the comparison of species tree models. Multispecies coalescent (MSC) models parameterize the discrete probability distribution of gene trees conditioned upon a species tree with a particular topology and set of divergence times (in coalescent units), and thus provide a framework for measuring distances between species tree models in terms of their corresponding gene tree topology probabilities. We describe the computation of probabilistic species tree distances in the context of standard MSC models, which assume complete genetic isolation postspeciation, as well as recent theoretical extensions to the MSC in the form of network-based MSC models that relax this assumption and permit hybridization among taxa. We demonstrate these metrics using simulations and empirical species tree estimates and discuss both the benefits and limitations of these approaches. We make our species tree distance approach available as an R package called pSTDistanceR, for open use by the community.


Assuntos
Classificação/métodos , Modelos Biológicos , Filogenia , Simulação por Computador , Software
8.
Syst Biol ; 69(1): 139-154, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31165169

RESUMO

We describe the use of the Fréchet mean and variance in the Billera-Holmes-Vogtmann (BHV) treespace to summarize and explore the diversity of a set of phylogenetic trees. We show that the Fréchet mean is comparable to other summary methods, and, despite its stickiness property, is more likely to be binary than the majority-rule consensus tree. We show that the Fréchet variance is faster and more precise than commonly used variance measures. The Fréchet mean and variance are more theoretically justified, and more robust, than previous estimates of this type and can be estimated reasonably efficiently, providing a foundation for building more advanced statistical methods and leading to applications such as mean hypothesis testing and outlier detection.


Assuntos
Classificação/métodos , Filogenia
9.
Syst Biol ; 69(1): 155-183, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31173141

RESUMO

We describe an "embarrassingly parallel" method for Bayesian phylogenetic inference, annealed Sequential Monte Carlo (SMC), based on recent advances in the SMC literature such as adaptive determination of annealing parameters. The algorithm provides an approximate posterior distribution over trees and evolutionary parameters as well as an unbiased estimator for the marginal likelihood. This unbiasedness property can be used for the purpose of testing the correctness of posterior simulation software. We evaluate the performance of phylogenetic annealed SMC by reviewing and comparing with other computational Bayesian phylogenetic methods, in particular, different marginal likelihood estimation methods. Unlike previous SMC methods in phylogenetics, our annealed method can utilize standard Markov chain Monte Carlo (MCMC) tree moves and hence benefit from the large inventory of such moves available in the literature. Consequently, the annealed SMC method should be relatively easy to incorporate into existing phylogenetic software packages based on MCMC algorithms. We illustrate our method using simulation studies and real data analysis.


Assuntos
Algoritmos , Classificação/métodos , Filogenia , Teorema de Bayes , Método de Monte Carlo , Software
10.
Syst Biol ; 69(1): 184-193, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31180508

RESUMO

Many recent species delimitation studies rely exclusively on limited analyses of genetic data analyzed under the multispecies coalescent (MSC) model, and results from these studies often are regarded as conclusive support for taxonomic changes. However, most MSC-based species delimitation methods have well-known and often unmet assumptions. Uncritical application of these genetic-based approaches (without due consideration of sampling design, the effects of a priori group designations, isolation by distance, cytoplasmic-nuclear mismatch, and population structure) can lead to over-splitting of species. Here, we argue that in many common biological scenarios, researchers must be particularly cautious regarding these limitations, especially in cases of well-studied, geographically variable, and parapatrically distributed species complexes. We consider these points with respect to a historically controversial species group, the American milksnakes (Lampropeltis triangulum complex), using genetic data from a recent analysis (Ruane et al. 2014). We show that over-reliance on the program Bayesian Phylogenetics and Phylogeography, without adequate consideration of its assumptions and of sampling limitations, resulted in over-splitting of species in this study. Several of the hypothesized species of milksnakes instead appear to represent arbitrary slices of continuous geographic clines. We conclude that the best available evidence supports three, rather than seven, species within this complex. More generally, we recommend that coalescent-based species delimitation studies incorporate thorough analyses of geographic variation and carefully examine putative contact zones among delimited species before making taxonomic changes.


Assuntos
Classificação/métodos , Filogeografia , Animais , Filogenia , Serpentes/classificação , Serpentes/genética
11.
PLoS One ; 14(12): e0226410, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851700

RESUMO

Current research revealed distinct changes in ecosystem functions, and thus in ecosystem stability and resilience, caused by changes in community structure and diversity loss. Benthic species play an important role in benthic-pelagic coupling, such as through the remineralization of deposited organic material, and changes to benthic community structure and diversity have associated with changes in ecosystem functioning, ecosystem stability and resilience. However, the long-term variability of traits and functions in benthic communities is largely unknown. By using abundance and bioturbation potential of macrofauna samples, taken along a transect from the German Bight towards the Dogger Bank in May 1990 and annually from 1995 to 2017, we analysed the taxonomic and trait-based macrofauna long-term community variability and diversity. Taxonomic and trait-based diversity remained stable over time, while three different regimes were found, characterised by changes in taxonomic and trait-based community structure. Min/max autocorrelation factor analysis revealed the climatic variables sea surface temperature (SST) and North Atlantic Oscillation Index (NAOI), nitrite, and epibenthic abundance as most important environmental drivers for taxonomic and trait-based community changes.


Assuntos
Organismos Aquáticos/classificação , Biodiversidade , Classificação/métodos , Clima , Ecossistema , Meio Ambiente , Mar do Norte , Fenótipo
12.
BMC Bioinformatics ; 20(1): 612, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775628

RESUMO

BACKGROUND: Maximum parsimony reconciliation in the duplication-transfer-loss model is a widely-used method for analyzing the evolutionary histories of pairs of entities such as hosts and parasites, symbiont species, and species and genes. While efficient algorithms are known for finding maximum parsimony reconciliations, the number of such reconciliations can be exponential in the size of the trees. Since these reconciliations can differ substantially from one another, making inferences from any one reconciliation may lead to conclusions that are not supported, or may even be contradicted, by other maximum parsimony reconciliations. Therefore, there is a need to find small sets of best representative reconciliations when the space of solutions is large and diverse. RESULTS: We provide a general framework for hierarchical clustering the space of maximum parsimony reconciliations. We demonstrate this framework for two specific linkage criteria, one that seeks to maximize the average support of the events found in the reconciliations in each cluster and the other that seeks to minimize the distance between reconciliations in each cluster. We analyze the asymptotic worst-case running times and provide experimental results that demonstrate the viability and utility of this approach. CONCLUSIONS: The hierarchical clustering algorithm method proposed here provides a new approach to find a set of representative reconciliations in the potentially vast and diverse space of maximum parsimony reconciliations.


Assuntos
Classificação/métodos , Biologia Computacional/métodos , Algoritmos , Análise por Conglomerados , Evolução Molecular , Modelos Genéticos , Filogenia
13.
Hist Philos Life Sci ; 41(4): 49, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31655927

RESUMO

In this paper, I investigate the variety and richness of the taxonomical practices between the end of the nineteenth and the early twentieth centuries. During these decades, zoologists and paleontologists came up with different quantitative practices in order to classify their data in line with the new biological principles introduced by Charles Darwin. Specifically, I will investigate Florentino Ameghino's mathematization of mammalian dentition and the quantitative practices and visualizations of several German-speaking paleontologists at the beginning of the twentieth century. In so doing, this paper will call attention to the visual and quantitative language of early twentieth-century systematics. My analysis will therefore contribute to a prehistory of the statistical frame of mind in biology, a study which has yet to be written in full. Second, my work highlights the productive intertwinement between biological practices and philosophical frameworks at the turn of the nineteenth century. Deeply rooted in Kantian bio-philosophy, several biologists sought to find rules in order to apply ordering principles to chaotic taxonomic information. This implies the necessity to investigate the neglected role of Kantian and Romantic bio-philosophy in the unfolding of twentieth-century biology.


Assuntos
Classificação/métodos , Paleontologia/história , Filosofia/história , Zoologia/história , Argentina , Alemanha , História do Século XIX , História do Século XX
14.
Hist Philos Life Sci ; 41(4): 40, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31591647

RESUMO

The taxa that appear in biological classifications are commonly seen as representing information about the traits of their member organisms. This paper examines in what way taxa feature in the storage and retrieval of such information. I will argue that taxa do not actually store much information about the traits of their member organisms. Rather, I want to suggest, taxa should be understood as functioning to localize organisms in the genealogical network of life on Earth. Taxa store information about where organisms are localized in the network, which is important background information when it comes to establishing knowledge about organismal traits, but it is not itself information about these traits. The view of species and higher taxa that is proposed here follows from examining three problems that occur in contemporary biological systematics and are discussed here: the problem of generalization over taxa, the problem of phylogenetic inference, and the problematic nature of the Tree of Life.


Assuntos
Biologia/métodos , Classificação/métodos , Evolução Biológica , Filogenia
15.
Genome Biol ; 20(1): 217, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640809

RESUMO

Current-day metagenomics analyses increasingly involve de novo taxonomic classification of long DNA sequences and metagenome-assembled genomes. Here, we show that the conventional best-hit approach often leads to classifications that are too specific, especially when the sequences represent novel deep lineages. We present a classification method that integrates multiple signals to classify sequences (Contig Annotation Tool, CAT) and metagenome-assembled genomes (Bin Annotation Tool, BAT). Classifications are automatically made at low taxonomic ranks if closely related organisms are present in the reference database and at higher ranks otherwise. The result is a high classification precision even for sequences from considerably unknown organisms.


Assuntos
Classificação/métodos , Genoma Microbiano , Metagenômica/métodos , Algoritmos , Fases de Leitura Aberta
16.
Nat Commun ; 10(1): 4643, 2019 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604942

RESUMO

Popular naive Bayes taxonomic classifiers for amplicon sequences assume that all species in the reference database are equally likely to be observed. We demonstrate that classification accuracy degrades linearly with the degree to which that assumption is violated, and in practice it is always violated. By incorporating environment-specific taxonomic abundance information, we demonstrate a significant increase in the species-level classification accuracy across common sample types. At the species level, overall average error rates decline from 25% to 14%, which is favourably comparable to the error rates that existing classifiers achieve at the genus level (16%). Our findings indicate that for most practical purposes, the assumption that reference species are equally likely to be observed is untenable. q2-clawback provides a straightforward alternative for samples from common environments.


Assuntos
Microbiota/genética , Filogenia , Bactérias/genética , Classificação/métodos , Biologia Computacional , Metagenômica/métodos , Densidade Demográfica , Software
17.
Hist Philos Life Sci ; 41(4): 46, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31624931

RESUMO

This paper addresses early modern botanical nomenclature, the practices of identifying and publishing synonyms in particular, as a collaborative "information science". Before Linnaean nomenclature became the lingua franca of botany, it was inevitable that, over time, the same plant was given several names by different people, which created confusion and made communication among botanists increasingly difficult. What names counted as synonyms and actually referred to the same plant had to be identified by meticulously comparing living and dried specimens of this and similar plants as well as relevant illustrations und descriptions in the botanical literature. Identifying synonyms required and generated an ever-expanding mass of data, which was used continuously to adjust and rearrange plant names. Despite the greatest care, judgements on synonyms were not definitive, which meant that published lists of synonyms for individual species of plants were in a state of flux and had to be constantly updated, corrected, and rewritten. This required long-term international collaborations, the accumulated results of which were not published once but consecutively, in augmented and corrected editions of a book. As a result of this networked approach, synonyms are networked names that reflect the epistemic interconnectedness of the botanical community. These questions will be discussed with a focus on the Dutch botanist Johannes Burman (1706-1779), who placed synonyms at the centre of his work as posthumous editor-and co-author-of the botanical manuscripts that were left behind by other botanists.


Assuntos
Botânica/história , Classificação/métodos , Plantas/classificação , Comunicação Acadêmica/história , Terminologia como Assunto , Europa (Continente) , História do Século XVIII , Países Baixos
18.
Artigo em Inglês | MEDLINE | ID: mdl-31623119

RESUMO

The study of diatoms-unicellular algae of the class Bacillariophyceae-has several applications, first and foremost the evaluation of freshwater ecosystem quality according to the Water Frame Directive 2000/60/EC (WFD). Identification at the species level is a crucial step in diatom studies, considering that species belonging to the same genus have different geographical distributions and different ecological requirements. The Rapid Method for Identification of Italian Diatom Species is aimed at guiding users in the classification of freshwater diatom species. It consists of a digitized flow chart that leads, step by step, to the identification, starting with an image capture by light or electron microscopy. This rapid and easy tool could be useful to workers of an environmental agency when performing the operational monitoring required by the WFD to classify surface waters. It will also expand the application of diatoms in numerous fields. This method has been patented in Italy.


Assuntos
Classificação/métodos , Diatomáceas/classificação , Monitoramento Ambiental/métodos , Itália
19.
Int J Med Inform ; 131: 103915, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31522022

RESUMO

BACKGROUND: Mortality surveillance is of fundamental importance to public health surveillance. The real-time recording of death certificates, thanks to Electronic Death Registration System (EDRS), provides valuable data for reactive mortality surveillance based on medical causes of death in free-text format. Reactive mortality surveillance is based on the monitoring of mortality syndromic groups (MSGs). An MSG is a cluster of medical causes of death (pathologies, syndromes or symptoms) that meets the objectives of early detection and impact assessment of public health events. The aim of this study is to implement and measure the performance of a rule-based method and two supervised models for automatic free-text cause of death classification from death certificates in order to implement them for routine surveillance. METHOD: A rule-based method was implemented using four processing steps: standardization rules, splitting causes of death using delimiters, spelling corrections and dictionary projection. A supervised machine learning method using a linear Support Vector Machine (SVM) classifier was also implemented. Two models were produced using different features (SVM1 based solely on surface features and SVM2 combining surface features and MSGs classified by the rule-based method as feature vectors). The evaluation was conducted using an annotated subset of electronic death certificates received between 2012 and 2016. Classification performance was evaluated on seven MSGs (Influenza, Low respiratory diseases, Asphyxia/abnormal respiration, Acute respiratory disease, Sepsis, Chronic digestive diseases, and Chronic endocrine diseases). RESULTS: The rule-based method and the SVM2 model displayed a high performance with F-measures over 0.94 for all MSGs. Precision and recall were slightly higher for the rule-based method and the SVM2 model. An error-analysis shows that errors were not specific to an MSG. CONCLUSION: The high performance of the rule-based method and SVM2 model will allow us to set-up a reactive mortality surveillance system based on free-text death certificates. This surveillance will be an added-value for public health decision making.


Assuntos
Causas de Morte , Classificação/métodos , Atestado de Óbito , Doença/classificação , Vigilância em Saúde Pública/métodos , Máquina de Vetores de Suporte , Adulto , Monitoramento Epidemiológico , França , Humanos , Masculino , Aprendizado de Máquina Supervisionado
20.
Int J Chron Obstruct Pulmon Dis ; 14: 1639-1655, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413559

RESUMO

Rationale: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 is based on an ABCD assessment tool of symptoms and exacerbation history and grade 1-4 of airflow limitation severity, facilitating classification either into 4 groups (ABCD) or 16 groups (1A-4D). We aimed to compare the GOLD 2011, GOLD 2017 ABCD, and GOLD 2017 1A-4D classifications in terms of their distribution and prediction of mortality and hospitalizations. Methods: In the GenKOLS study, 912 COPD patients with FEV1 less than 80% of the predicted answered questionnaires and performed lung function testing in 2003-2005. The patients were recruited from a hospital patient registry (n=662) and from the general population (n=250), followed up until 2011 with respect to all-cause and respiratory mortality, and all-cause and respiratory hospitalizations. We performed logistic regression and receiver operating curve (ROC) analyses for the different classifications with estimations of area under the curve (AUC) for comparisons. Results: Mean age at baseline was 60 years (SD 11), 55% were male. Mean duration of follow-up was 91 months. By GOLD 2011, 21% were classified as group A, 29% group B, 6% group C, and 43% as group D, corresponding percentages for GOLD 2017 were: 25%, 52%, 3%, and 20%. The GOLD 2011 classification had higher AUC values than the GOLD 2017 group ABCD classification for respiratory mortality and hospitalization, but after inclusion of airflow limitation severity in GOLD 2017 groups 2A-4D, AUC values were significantly higher with GOLD 2017. Conclusion: In a clinically relevant sample of COPD patients, the GOLD 2017 classification doubles the prevalence of group B and halves the prevalence of groups C and D as compared to the GOLD 2011 classification. The prediction of respiratory mortality and respiratory hospitalization was better for GOLD 2017 2A-4D taking airflow limitation severity into account, as compared to GOLD 2017 ABCD and GOLD 2011.


Assuntos
Classificação/métodos , Doença Pulmonar Obstrutiva Crônica , Testes de Função Respiratória , Área Sob a Curva , Progressão da Doença , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Prevalência , Prognóstico , Doença Pulmonar Obstrutiva Crônica/classificação , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/mortalidade , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Sistema de Registros/estatística & dados numéricos , Testes de Função Respiratória/métodos , Testes de Função Respiratória/estatística & dados numéricos , Índice de Gravidade de Doença
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