Respiratory Rehabilitation Index (R2I): Unsupervised Clustering Approach to Identify COPD Subgroups Associated with Rehabilitation Outcomes Article Swipe
YOU?
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· 2025
· Open Access
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· DOI: https://doi.org/10.3390/diagnostics15162053
Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a progressive condition whose heterogeneous endotypes, clinical manifestations, and recovery pathways complicate the identification of reliable predictors of rehabilitation outcomes. Several respiratory and functional assessments are available with no consensus on the most predictive ones. While univariate markers may miss multifactorial interactions essential for prognosis, data-driven unsupervised clustering methods can integrate complex information from different sources. This study aimed to apply unsupervised clustering to identify pre-rehabilitation characteristics predictive of discharge outcomes for COPD patients undergoing pulmonary rehabilitation. Methods: A total of 126 COPD patients undergoing pulmonary rehabilitation were included in the analysis. Three assessments were performed at admission, namely the forced oscillation technique, spirometry, and the six-minute walk test (6MWT). The outcome was the change in 6MWT distance between admission and discharge. Unsupervised clustering methods were applied to admission variables to identify subgroups associated with outcomes. Results: Among the clustering algorithms tested, k-means (with Ncl = 2) provided the optimal solution. The resulting respiratory rehabilitation index (R2I) was significantly associated with the outcome dichotomized via the minimal clinically important difference of 30 m. Patients with R2I = 1, indicating severe functional and respiratory impairments, were associated with higher post-rehabilitation functional improvement (p = 0.032). While few functional parameters of 6MWT were statistically different between the groups identified by outcome, nearly all variables in the analysis exhibited significant distribution differences among the R2I clusters. Conclusions: These findings highlight the heterogeneity of COPD and the potential of unsupervised clustering to identify distinct patient subgroups, enabling more personalized rehabilitation strategies.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/diagnostics15162053
- https://www.mdpi.com/2075-4418/15/16/2053/pdf?version=1755329881
- OA Status
- gold
- References
- 39
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4413293231
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4413293231Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/diagnostics15162053Digital Object Identifier
- Title
-
Respiratory Rehabilitation Index (R2I): Unsupervised Clustering Approach to Identify COPD Subgroups Associated with Rehabilitation OutcomesWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-08-16Full publication date if available
- Authors
-
Erin Marra, Piergiuseppe Liuzzi, Andrea Mannini, Paola Romagnoli, Francesco GigliottiList of authors in order
- Landing page
-
https://doi.org/10.3390/diagnostics15162053Publisher landing page
- PDF URL
-
https://www.mdpi.com/2075-4418/15/16/2053/pdf?version=1755329881Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.mdpi.com/2075-4418/15/16/2053/pdf?version=1755329881Direct OA link when available
- Concepts
-
COPD, Medicine, Pulmonary rehabilitation, Rehabilitation, Spirometry, Cluster analysis, Physical therapy, Physical medicine and rehabilitation, Internal medicine, Machine learning, Computer science, AsthmaTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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39Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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