Symptom-Based Questionnaire for Identifying COPD in Smokers
- 1 May 2006
- journal article
- research article
- Published by S. Karger AG in Respiration
- Vol. 73 (3), 285-295
- https://doi.org/10.1159/000090142
Abstract
Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care. We prospectively tested questions to help identify COPD among smokers without prior history of lung disease. Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo., USA. Current and former smokers aged 40 or older with no prior respiratory diagnosis and no respiratory medications in the past year were enrolled. Participants answered questions covering demographics and symptoms and then underwent spirometry with reversibility testing. A study diagnosis of COPD was defined as fixed airway obstruction as measured by post-bronchodilator FEV(1)/FVC <0.70. We examined the ability of individual questions in a multivariate framework to correctly discriminate between persons with and without COPD. 818 subjects completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analysis, which was reduced to 17 items for entry into multivariate regression. Eight items had significant relationships with the study diagnosis of COPD, including age, pack-years, body mass index, weather-affected cough, phlegm without a cold, morning phlegm, wheeze frequency, and history of any allergies. Individual items yielded odds ratios ranging from 0.23 to 12. This questionnaire demonstrated a sensitivity of 80.4 and specificity of 72.0. A simple patient self-administered questionnaire can be used to identify patients with a high likelihood of having COPD, for whom spirometric testing is particularly important. Implementation of this questionnaire could enhance the efficiency and diagnostic accuracy of current screening efforts.Keywords
This publication has 22 references indexed in Scilit:
- Development of a Population-Based Screening Questionnaire for COPDCOPD: Journal of Chronic Obstructive Pulmonary Disease, 2005
- Newly Diagnosed Chronic Obstructive Pulmonary DiseaseRespiration, 2003
- Worldwide guidelines for chronic obstructive pulmonary disease: A comparison of diagnosis and treatment recommendationsRespirology, 2002
- Detecting patients at a high risk of developing chronic obstructive pulmonary disease in general practice: cross sectional case finding studyBMJ, 2002
- Spirometry and Obstructive Lung Disease in ManitobaCanadian Respiratory Journal, 2001
- Office Spirometry for Lung Health Assessment in AdultsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2000
- The Impact of COPD on Lung Health WorldwideSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2000
- Strategies in Preserving Lung Health and Preventing COPD and Associated DiseasesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1998
- How to Avoid Underdiagnosed Asthma/Chronic Obstructive Pulmonary Disease?Journal of Asthma, 1998
- Association between health-related quality of life and consultation for respiratory symptoms: results from the DIMCA programmeEuropean Respiratory Journal, 1998