Exacerbation rate needs to be updated to explicitly incorporate diagnosis

[KateJohnson]

Adjustment to the overall exacerbation rate to incorporate undiagnosed patients need to be undone.

[KateJohnson]

Check the expected annual rate of severe exacerbations for the Canadian population (should be 100K)

[KateJohnson]

Exacerbation rate has been recalibrated now that diagnosis is added (Intercept: -0.4).

We calibrated to:

• Hoogendoorn IJCOPD 2010 rate of severe exacerbations by GOLD stage (in diagnosed patients)
• CIHI annual number of COPD hospitalizations (100K) (in diagnosed patients)
• Labonte AJRCCM 2016 exacerbation rate by diagnosis status

Additional targets:

• 0.29 of GOLD 1 and 2 diagnosed in CanCOLD
• 33-40% diagnosed in hospital (BC Admin data, Balcells et al.)

We did not calibrate to Hoogendoorn IJCOPD 2010 rate of all exacerbations because most studies in this meta-analysis were clinical trials; they overestimate the rate of exacerbations compared to the general population.