{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T21:17:22Z","timestamp":1768684642977,"version":"3.49.0"},"reference-count":15,"publisher":"BMJ","issue":"12","funder":[{"name":"Almirall BV, Utrecht, The Netherlands"},{"name":"the Innovation Fund Dutch Health Insurers, Zeist, The Netherlands"},{"name":"GlaxoSmithKline BV, Zeist, The Netherlands"},{"name":"Chiesi Pharmaceuticals BV, Rijswijk, The Netherlands"},{"name":"Novartis BV, Arnhem, The Netherlands"},{"name":"AstraZeneca BV, Zoetermeer, The Netherlands"},{"name":"Picasso for COPD, Alkmaar, The Netherlands"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,8,18]]},"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The Assessment of Burden of COPD (ABC) tool supports shared decision making between patient and caregiver. It includes a coloured balloon diagram to visualise patients\u2019 scores on burden indicators. We aim to determine the importance of each indicator from a patient perspective, in order to calculate a weighted index score and investigate whether that score is predictive of costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Discrete choice experiment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>Primary care and secondary care in the Netherlands. 282 patients with chronic obstructive pulmonary disease (COPD) and 252 members of the general public participated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Respondents received 14 choice questions and indicated which of two health states was more severe. Health states were described in terms of specific symptoms, limitations in physical, daily and social activities, mental problems, fatigue and exacerbations, most of which had three levels of severity. Weights for each item-level combination were derived from a Bayesian mixed logit model. Weights were rescaled to construct an index score from 0 (best) to 100 (worst). Regression models were used to find a classification of this index score in mild, moderate and severe that was discriminative in terms of healthcare costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fatigue, limitations in moderate physical activities, number of exacerbations, dyspnoea at rest and fear of breathing getting worse contributed most to the burden of disease. Patients assigned less weight to dyspnoea during exercise, listlessness and limitations with regard to strenuous activities. Respondents from the general public mostly agreed. Mild, moderate and severe burden of disease were defined as scores &lt;20, 20\u201339 and \u226540. This categorisation was most predictive of healthcare utilisation and annual costs: \u20ac1368, \u20ac2510 and \u20ac9885, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The ABC\n                      <jats:underline>I<\/jats:underline>\n                      ndex is a new index score for the burden of COPD, which is based on patients\u2019 preferences. The classification of the index score into mild, moderate and severe is predictive of future healthcare costs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NTR3788; Post-results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017831","type":"journal-article","created":{"date-parts":[[2017,12,26]],"date-time":"2017-12-26T23:41:19Z","timestamp":1514331679000},"page":"e017831","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["ABC Index: quantifying experienced burden of COPD in a discrete choice experiment and predicting costs"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-4887","authenticated-orcid":false,"given":"Lucas MA","family":"Goossens","sequence":"first","affiliation":[{"name":"Erasmus School of Health Policy and Management & Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen PMH","family":"Rutten-van M\u00f6lken","sequence":"additional","affiliation":[{"name":"Erasmus School of Health Policy and Management & Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinde RS","family":"Boland","sequence":"additional","affiliation":[{"name":"Erasmus School of Health Policy and Management & Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas","family":"Donkers","sequence":"additional","affiliation":[{"name":"Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel F","family":"Jonker","sequence":"additional","affiliation":[{"name":"Erasmus School of Health Policy and Management & Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annerika HM","family":"Slok","sequence":"additional","affiliation":[{"name":"CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe L","family":"Salom\u00e9","sequence":"additional","affiliation":[{"name":"Huisartsenco\u00f6peratie PreventZorg, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onno CP","family":"van Schayck","sequence":"additional","affiliation":[{"name":"CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes CCM","family":"in \u2019t Veen","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elly A","family":"Stolk","sequence":"additional","affiliation":[{"name":"Erasmus School of Health Policy and Management & Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"EuroQol Foundation, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,12,26]]},"reference":[{"key":"2025121400085140000_7.12.e017831.1","unstructured":"World Health Organization. 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