Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting

BACKGROUND: To assist clinicians and researchers in choosing outcome measures for patients with chronic obstructive pulmonary disease attending routine outpatient clinics, a comparative assessment was undertaken of four questionnaires designed to reflect the patients' perception of their physical and emotional health in terms of their feasibility, validity, reliability, and responsiveness to health change. METHODS: Two condition specific questionnaires, the St George's Respiratory Questionnaire (SGRQ) and Guyatt's Chronic Respiratory Questionnaire (CRQ), and two generic questionnaires, the Short Form-36 Health Survey (SF-36) and Euroqol (EQ), were compared for their discriminative and evaluative properties. Spirometric tests and a walking test were also performed. One hundred and fifty six adults who were clinically judged to have COPD and who attended an outpatient chest clinic were assessed at recruitment and six and 12 months later. Patients were also asked whether their health had changed since their last assessment. RESULTS: Completion rates and consistency between items for dimensions of the SGRQ were lower than for dimensions of the other questionnaires. The distributions of responses were skewed for certain dimensions in all questionnaires except the CRQ. Validity was supported for all instruments insofar as patients' scores were associated with differences in disease severity. The generic questionnaires better reflected other health problems. All instruments were reliable over time. The condition specific questionnaires were more responsive between baseline and first follow up visit but this difference did not persist. While certain dimensions of the SF-36 were responsive to patient perceived changes, this did not apply to the derived single index of the EQ. The rating scale of the EQ, however, provided a quick and easy indicator of change. CONCLUSIONS: Evidence from this study supports the CRQ and the SF-36 as comprehensive outcome measures for patients with longstanding COPD

Some genus 3 curves with many points

Using an explicit family of plane quartic curves, we prove the existence of a genus 3 curve over any finite field of characteristic 3 whose number of rational points stays within a fixed distance from the Hasse-Weil-Serre upper bound. We also provide an intrinsic characterization of so-called Legendre elliptic curves

The Progenitor Masses of Wolf-Rayet Stars and Luminous Blue Variables Determined from Cluster Turn-offs. II. Results from 12 Galactic Clusters and OB Associations

Here we examine 12 Galactic clusters and OB associations containing Wolf-Rayet stars (W-Rs) and/or Luminous Blue Variables (LBVs), in order to assess the progentor masses of these evolved massive stars. We find that in the Milky Way, early-type WN stars evolve from stars with masses as low as 20Mo. Some early-type WN stars are found in clusters with very high turn-off masses, supporting our earlier results that the "WNE" class of W-Rs is a common stage in the evolution of stars with a wide range of mases. In contrast, the late-type WNs (particularly those of WN7 class) and the LBVs are only found in clusters with the very highest turn-off masses, suggesting that only the most massive stars evolve to these objects. An examination of the environment of the archetype LBV Eta Car reveals that this star is coeval with the rest of the Tr14/16 association, suggesting that its LBV properties is a normal consequence of evolution, and has little to do with the possibility that it is a binary.Comment: Scheduled for the Feb 2001 issue of the Astronomical Journal. Postscript version including figs from ftp://ftp.lowell.edu/pub/massey/galwr.ps.g