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- Hebebrand, J., et al.
(författare)
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A Proposal of the European Association for the Study of Obesity to Improve the ICD-11 Diagnostic Criteria for Obesity Based on the Three Dimensions Etiology, Degree of Adiposity and Health Risk
- 2017
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Ingår i: Obesity Facts. - : S. Karger AG. - 1662-4025 .- 1662-4033. ; 10:4, s. 284-307
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Tidskriftsartikel (refereegranskat)abstract
- Diagnostic criteria for complex medical conditions caused by a multitude of both genetic and environmental factors should be descriptive and avoid any attribution of causality. Furthermore, the wording used to describe a disorder should be evidence-based and avoid stigmatization of the affected individuals. Both terminology and categorizations should be readily comprehensible for healthcare professionals and guide clinical decision making. Uncertainties with respect to diagnostic issues and their implications may be addressed to direct future clinical research. In this context, the European Association of the Study of Obesity (EASO) considers it an important endeavor to review the current ICD-11 Beta Draft for the definition of overweight and obesity and to propose a substantial revision. We aim to provide an overview of the key issues that we deem relevant for the discussion of the diagnostic criteria. We first discuss the current ICD-10 criteria and those proposed in the ICD 11 Beta Draft. We conclude with our own proposal for diagnostic criteria, which we believe will improve the assessment of patients with obesity in a clinically meaningful way. (C) 2017 The Author(s) Published by S. Karger GmbH, Freiburg
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| 2. |
- Lissner, Lauren, 1956, et al.
(författare)
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Statement by Members of the Task Force on Prevention and Public Health of the European Association for the Study of Obesity (EASO)
- 2009
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Ingår i: Obesity Facts. - 1662-4025. ; 2:1, s. 54-55
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Tidskriftsartikel (refereegranskat)abstract
- This document is signed by all members of the task force, who will contribute knowledge on the problem of obesity in the various regions of Europe. It is apparent from the wide range of available prevalence estimates that the magnitude of the obesity epidemic varies across Europe. However certain similarities are present, including consistent but varying increases in prevalence in all countries from the end of the 20th century to the present, together with clear inverse socioeconomic gradients. The lack of harmonized surveillance efforts across Europe makes international monitoring and comparative assessments imprecise at best. A particularly worrisome aspect of this epidemic is the recently observed increase in the proportion of European children with overweight and obesity. The Task Force is in agreement that the epidemic reflects changing lifestyles and environments and that prevention can only be achieved by identifying and arresting these trends, a statement that has been repeated by many groups advocating obesity prevention over the years. For instance, in 1999 the Milan Declaration was made on behalf of all members of the EASO, resolving to support the development of coherent national and Europe-wide strategies for the prevention and management of overweight and obesity. Since then, there have been recent steps to develop a public health strategy for obesity prevention across Europe, including most notably the 2006 European Ministerial Conference on Counteracting Obesity in the European Region. At that time, all member states of WHO Europe met in Istanbul and explicitly agreed on an ecological approach to fighting the obesity epidemic, with a charter recognizing that counteracting obesity requires a multidisciplinary effort with a timeline for improvements (www.euro.who.int/ document/E89567.pdf). In this context, the vision of our Task Force is to provide guidance and leadership to researchers, governments, and agencies that are trying to fulfill the charter developed in Istanbul and other recent initiatives. Specifically, we will support and strengthen research and interventions to improve prevention of obesity across Europe, within the framework of the EASO.
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| 3. |
- Reddel, Helen K., et al.
(författare)
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Heterogeneity within and between physician-diagnosed asthma and/or COPD : NOVELTY cohort
- 2021
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 58:3
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies of asthma and chronic obstructive pulmonary disease (COPD) typically focus on these diagnoses separately, limiting understanding of disease mechanisms and treatment options. NOVELTY is a global, 3-year, prospective observational study of patients with asthma and/or COPD from real-world clinical practice. We investigated heterogeneity and overlap by diagnosis and severity in this cohort. Methods Patients with physician-assigned asthma, COPD or both (asthma+COPD) were enrolled, and stratified by diagnosis and severity. Baseline characteristics were reported descriptively by physician-assigned diagnosis and/or severity. Factors associated with physician-assessed severity were evaluated using ordinal logistic regression analysis. Results Of 11243 patients, 5940 (52.8%) had physician-assigned asthma, 1396 (12.4%) had asthma+COPD and 3907 (34.8%) had COPD; almost half were from primary care. Symptoms, health-related quality of life and spirometry showed substantial heterogeneity and overlap between asthma, asthma COPD and COPD, with 23%, 62% and 64% of patients, respectively, having a ratio of post-bronchodilator forced expiratory volume in 1 s to forced vital capacity below the lower limit of normal. Symptoms and exacerbations increased with greater physician-assessed severity and were higher in asthma+COPD. however, 24.3% with mild asthma and 20.4% with mild COPD had experienced >= 1 exacerbation in the past 12 months. Medication records suggested both under-treatment and over-treatment relative to severity. Blood eosinophil counts varied little across diagnosis and severity groups, but blood neutrophil counts increased with severity across all diagnoses. Conclusion This analysis demonstrates marked heterogeneity within, and overlap between, physician-assigned diagnosis and severity groups in patients with asthma and/or COPD. Current diagnostic and severity classifications in clinical practice poorly differentiate between clinical phenotypes that may have specific risks and treatment implications.
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