Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of a Home-based Versus a Hospital-based Outpatient Pulmonary Rehabilitation Program in Patients With COPD: a Multicenter, Randomized Trial
Brief Summary: Short term efficacy of pulmonary rehabilitation for improving functional capacity and quality of life of chronic obstructive respiratory disease (COPD) patient is well known. However, there is an important gap between the scientific knowledge and the clinical use of pulmonary rehabilitation since a a very small number of patients benefit from this therapeutic intervention. We estimate that less than 1% of the 750 000 canadians suffering from COPD have access to a pulmonary rehabilitation program. We want to study the efficacy of a home-based rehabilitation program as a way to facilitate the access to rehabilitation.


Options:
A: Inclusion Criteria:

* All persons with a diagnosis of COPD (ICD-10:J44:9) who visit included primary care units due to their COPD.
* Needs to understand and read Swedish.
* Needs to have a smartphone, tablet or computer with access to internet.
* In case of exacerbation, the participant has to wait at least 6 weeks after initiated pharmacological treatment, before being eligible in the study.

Exclusion Criteria:

* Not COPD
* Dementia or other psychiatric condition that can prevent understanding of the intervention.
* Serious comorbidity that can be considered as the contributing factor for limitation in physical activity.
* Has an account on the COPD Web.
B: Inclusion Criteria:

* Subject is able to ambulate. Defined as a 6MWD greater than 110 meters.
* Subject is diagnosed with COPD.
* 40 years-old and older
* Currently or previously smoking with a smoking history of at least 10 pack-years.
* Forced expiratory volume on one second (FEV1) after the use of a bronchodilator between 25 an 70% of the predicted value, and FEV1 to forced vital capacity ratio less than 70%.
* No previous diagnosis of asthma, left heart congestive heart failure (either radiographic evidence of pulmonary congestion, echocardiographic or ventriculographic evidence of a reduced ventricular ejection fraction), terminal disease, dementia or uncontrolled psychiatric illness.
* Never participated to a respiratory rehabilitation program and not staying or planning to stay in a long term care facility.
* Subject understands and is able to read and write French or English.
* MRC dyspnea scale of at least 2.

Exclusion Criteria:

* The need for supplemental oxygen at rest or during exercise will not be an exclusion criterion.
C: Inclusion Criteria:

* severe and very severe COPD (i.e. with an FEV1 (forced expiratory volume in 1 second) value under 50% of the predicted value, an FEV1/FVC (forced vital capacity) ratio \< 70%, MRC (Medical Research Council Dyspnoea Scale) grade 3)
* ≥40 years
* hospitalization with exacerbation of COPD
* declined participation in the hospital based rehabilitation
* participation in videoconference sessions with a nurse for one week immediately after discharge.

Exclusion Criteria:

* inability to communicate via telephone and computer
* systolic BP \<100mm Hg
* X-rays of the thorax showing abnormalities suspicious of thoracic malignancy or lobar pneumonia
* a diagnosis of cancer or recurrence of cancer within the last 5 years
* hospitalization with septic shock, acute myocardial infarction (AMI) or other serious medical conditions (e.g. kidney disorder)
* heart failure (EF\<30%)
* if the patient did not wish to participate.
D: Inclusion Criteria:

* Hospital discharge diagnosis of COPD
* Spirometry-confirmed evidence of COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I to IV
* Access to internet connection and knowledge on use of web-based programs

Exclusion Criteria:

* Persons with additional significant comorbidities including cancer, cardiac disease and physical impairments
* Non-English speaking persons
* The inability to provide an informed consent

Answer: B