My coauthors and I thank Dr. Don Eby for his interest in our article.1,2
I have 37 years of experience working in a large emergency department and am very familiar with the complexities of making admission decisions. In our paper, my coauthors and I go to great lengths to indicate that medical risk of a poor outcome is only 1 factor to consider, along with many others. The following quotation is taken from the article’s Interpretation section:
Many nonmedical factors are important in the decision to admit a patient, such as support at home or availability of early follow-up. We see OCRS [Ottawa COPD (chronic obstructive pulmonary disease) Risk Scale] as an important tool to help physicians gauge the medical risk for their patients with COPD, while they determine the need for admission or early follow-up.2
Footnotes
Competing interests: None declared.
References
- 1.Eby D. Most important risk factor missing from COPD score [letter]. CMAJ 2019;191:E370. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Stiell IG, Perry JJ, Clement CM, et al. Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department. CMAJ 2018;190:E1406–13. [DOI] [PMC free article] [PubMed] [Google Scholar]