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Original Research

Validation of ACCESS: an automated tool to support self-management of COPD exacerbations

, , , , , , & show all
Pages 3255-3267 | Published online: 10 Oct 2018

Figures & data

Figure 1 Content of ACCESS.

Abbreviations: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support; SpO2, peripheral capillary oxygen saturation; FEV1, forced expiratory volume in one second.

Figure 1 Content of ACCESS.Abbreviations: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support; SpO2, peripheral capillary oxygen saturation; FEV1, forced expiratory volume in one second.

Figure 2 Expert decision model of ACCESS advice.

Abbreviations: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support; SpO2, peripheral capillary oxygen saturation; FEV1, forced expiratory volume in one second.
Figure 2 Expert decision model of ACCESS advice.

Table 1 Baseline characteristics of the study population (n=54) represented in mean (SD), median (IQR), or frequency (%)

Figure 3 Flowchart of patient participation in the study.

Figure 3 Flowchart of patient participation in the study.

Figure 4 Representation of percentages of times each advice was provided by ACCESS, based on 2,928 diary cards. On each day, more than one advice could be provided.

Abbreviation: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support.
Figure 4 Representation of percentages of times each advice was provided by ACCESS, based on 2,928 diary cards. On each day, more than one advice could be provided.

Table 2 Cross-tabulation of symptom-based exacerbationsTable Footnotea vs the advice to contact a health care professional given by ACCESS

Figure 5 Representation of reasons for ACCESS’ advice to contact a health care professional, in the absence of a symptom-based exacerbation (n=725). In each event, more than one reason may apply.

Notes: 1) A worsening of at least 2 consecutive days in two or more major symptoms (dyspnea, sputum purulence, sputum amount) or a change in any one major symptom plus a cold and/or wheeze and/or sore throat and/or cough and/or fatigue; 2) dyspnea and/or wheeze and dyspnea and/or wheeze the previous day; 3) decrease in FEV1 is 10% or more of personal best; 4) increased dyspnea and increased bronchodilator use; 5) decrease in SpO2 is 4% or more of personal best; 6) risk calculation of Bayesian network is higher than 85%; 7) a worsening of two or more major symptoms (dyspnea, sputum purulence, sputum amount); 8) fifth consecutive day that advice “measure again tomorrow” (indication of worsening of any symptom) is given; 9) increased dyspnea and fear of increased dyspnea; 10) third day of increased wheeze and increased bronchodilator use; 11) any one major symptom (dyspnea, sputum purulence, sputum amount) and fever (see also ).
Abbreviation: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support; SpO2, peripheral capillary oxygen saturation; FEV1, forced expiratory volume in one second.
Figure 5 Representation of reasons for ACCESS’ advice to contact a health care professional, in the absence of a symptom-based exacerbation (n=725). In each event, more than one reason may apply.

Table 3 Cross-tabulation of event-based exacerbationsTable Footnotea vs the advice to contact a health care professional given by ACCESS

Figure S1 Schematic presentation of the ACCESS system.

Abbreviation: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support.

Figure S1 Schematic presentation of the ACCESS system.Abbreviation: ACCESS, Adaptive Computerized COPD Exacerbation Self-management Support.

Figure S2 Schematic overview of the development of the Adaptive Computerized COPD Exacerbation Self-management Support (ACCESS) System.

Figure S2 Schematic overview of the development of the Adaptive Computerized COPD Exacerbation Self-management Support (ACCESS) System.

Figure S3 ROC curve of cutoff values of the Bayesian network model’s risk calculation to identify a symptom-based exacerbation.

Abbreviations: ROC, receiver operating curve; AUC, area under the curve.

Figure S3 ROC curve of cutoff values of the Bayesian network model’s risk calculation to identify a symptom-based exacerbation.Abbreviations: ROC, receiver operating curve; AUC, area under the curve.