{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:47:58Z","timestamp":1782406078788,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006041","name":"Innovate UK","doi-asserted-by":"publisher","award":["101024"],"award-info":[{"award-number":["101024"]}],"id":[{"id":"10.13039\/501100006041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2026,4,13]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Identifying people with chronic obstructive pulmonary disease (COPD) who are at high risk of significant health events such as exacerbations and hospital admissions is clinically important to guide optimisation of preventative interventions. We evaluated the utility of the Global Initiative for Obstructive Lung Disease (GOLD) 2026 ABE assessment tool which stratifies based on exacerbations or symptoms to distinguish these patients at high risk.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      664 participants from the ERICA (\n                      <jats:italic>E<\/jats:italic>\n                      valuation of the\n                      <jats:italic>R<\/jats:italic>\n                      ole of\n                      <jats:italic>I<\/jats:italic>\n                      nflammation in\n                      <jats:italic>C<\/jats:italic>\n                      hronic\n                      <jats:italic>A<\/jats:italic>\n                      irways Disease) COPD cohort were classified into GOLD ABE groups using both the Chronic Airways Assessment Tool (CAAT) score and the modified Medical Research Council (mMRC) breathlessness scale to define the degree of symptoms. National Health Service hospital episode statistics data were prospectively collected for a median follow-up of 4.75 years. Hospital admissions, including for acute exacerbations of COPD (H-AECOPD (hospitalised acute exacerbations of COPD)), were evaluated. Logistic regression analyses with ORs adjusted for potential confounding factors were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using CAAT, n=43\/182\/439 (7%\/27%\/66%) of participants were in groups A, B and E, respectively. By mMRC, n=144\/81\/439 (22%\/12%\/66%) were in groups A, B and E. The ABE tool derived using both CAAT and mMRC predicted H-AECOPD over follow-up. For group B versus group A by CAAT, the OR was 3.72 (95% CI 1.09 to 12.73, p=0.04), and for group E versus group A the OR was 8.13 (95% CI 2.45 to 26.92, p&lt;0.001). By mMRC, for group B versus group A the OR was 2.69 (95% CI 1.36 to 5.32, p=0.005) and for group E versus group A the OR was 4.05 (95% CI 2.38 to 6.05, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this prospective real-world UK cohort, the simple GOLD 2026 ABE tool identified patients with high-risk COPD for severe exacerbations (H-AECOPD). The differences in groups A and B classification depending on whether the CAAT score or mMRC scale is used have clinical implications that need consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-004075","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:10:23Z","timestamp":1782403823000},"page":"e004075","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["GOLD 2026 COPD ABE assessment tool to identify individuals at high risk in a UK multicentre COPD cohort (ERICA)"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2843-7649","authenticated-orcid":false,"given":"Gbenga","family":"Adesoye","sequence":"first","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6735-2567","authenticated-orcid":false,"given":"Alastair","family":"Watson","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5900-0626","authenticated-orcid":false,"given":"Tengyu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-2249","authenticated-orcid":false,"given":"Charlotte E","family":"Bolton","sequence":"additional","affiliation":[{"name":"NIHR Nottingham BRC Respiratory Theme, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J","family":"Smith","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Fuld","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel","family":"McEniery","sequence":"additional","affiliation":[{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Cheriyan","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Cockcroft","sequence":"additional","affiliation":[{"name":"Cardiff Metropolitan University, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"MacNee","sequence":"additional","affiliation":[{"name":"The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Tal-Singer","sequence":"additional","affiliation":[{"name":"Global Allergy and Airways Patient Platform, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Polkey","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian B","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1292-7642","authenticated-orcid":false,"given":"Marie","family":"Fisk","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"2026062509101730000_13.1.e004075.1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"8","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2026062509101730000_13.1.e004075.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01273-9"},{"key":"2026062509101730000_13.1.e004075.3","unstructured":"COPD in the UK : Asthma lung uk executive summary and recommendations. 2022. 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