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A second sample of 381 patients with COPD was used for validation. Nine TTs were assessed: current smoking status, activity-related dyspnoea, frequent exacerbations &lt;12\u2005months, severe fatigue, depressed mood, poor physical capacity, low physical activity, poor nutritional status and a low level of self-management activation. For each TT the odds ratio (OR) of having a severe health status impairment was calculated. Furthermore, a graphic representation was created, the COPD sTRAITosphere, to visualise TTs prevalence and OR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On average 3.9\u00b12.0 TTs per patient were observed. These TTs occurred relatively independently of each other and coexisted in 151 unique combinations. A significant positive correlation was found between the number of TTs and Clinical COPD Questionnaire total score (r=0.58; p&lt;0.001). Patients with severe fatigue (OR: 8.8), severe activity-related dyspnoea (OR: 5.8) or depressed mood (OR: 4.2) had the highest likelihood of having a severely impaired health status. The validation sample corroborated these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Upon first referral to a pulmonologist, COPD patients show multiple TTs indicating them to several nonpharmacological interventions. These TTs coexist in many different combinations, are relatively independent and increase the likelihood of having a severely impaired health status.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00438-2020","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T17:22:22Z","timestamp":1600363342000},"page":"00438-2020","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Treatable traits qualifying for nonpharmacological interventions in COPD patients upon first referral to a pulmonologist: the COPD sTRAITosphere"],"prefix":"10.1183","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5514-2327","authenticated-orcid":false,"given":"Alex J.","family":"van \u2019t Hul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonore H.","family":"Koolen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine C.","family":"Antons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"de Man","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remco S.","family":"Djamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes C.C.M.","family":"in \u2019t Veen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami O.","family":"Simons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"van den Heuvel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"van den Borst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-7430","authenticated-orcid":false,"given":"Martijn A.","family":"Spruit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"2024101710511706000_6.4.00438-2020.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31222-9"},{"key":"2024101710511706000_6.4.00438-2020.2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0027-2018"},{"key":"2024101710511706000_6.4.00438-2020.3","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.2147\/COPD.S175706","article-title":"Personalized medicine for patients with COPD: where are we?","volume":"14","author":"Franssen","year":"2019","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024101710511706000_6.4.00438-2020.4","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01655-2017"},{"key":"2024101710511706000_6.4.00438-2020.5","doi-asserted-by":"crossref","first-page":"e0201593","DOI":"10.1371\/journal.pone.0201593","article-title":"The respiratory physiome: clustering based on a comprehensive lung function assessment in patients with COPD","volume":"13","author":"Augustin","year":"2018","journal-title":"PLoS ONE"},{"key":"2024101710511706000_6.4.00438-2020.6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1634ST"},{"key":"2024101710511706000_6.4.00438-2020.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.04.004"},{"key":"2024101710511706000_6.4.00438-2020.8","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X708101"},{"key":"2024101710511706000_6.4.00438-2020.9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.rmed.2016.07.015","article-title":"Burden of COPD in patients treated in different care settings in the Netherlands","volume":"118","author":"Smid","year":"2016","journal-title":"Respir Med"},{"key":"2024101710511706000_6.4.00438-2020.10","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/s41533-018-0097-3","article-title":"The physical, mental, and social impact of COPD in a population-based sample: results from the Longitudinal Aging Study Amsterdam","volume":"28","author":"Franssen","year":"2018","journal-title":"NPJ Prim Care Respir Med"},{"key":"2024101710511706000_6.4.00438-2020.11","unstructured":"van Kemenade YW . 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