Screening performance of COPD-PS scale, COPD-SQ scale, peak expiratory flow, and their combinations for chronic obstructive pulmonary disease in the primary healthcare in Haicang District, Xiamen City
Authors:
Open Access
- 9 April 2024
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Medicine
- Vol. 11, 1357077
Abstract
Objectives: This study aimed to evaluate the screening performance of COPD-PS questionnaire, COPD-SQ questionnaire, peak expiratory flow (PEF), COPD-PS questionnaire combined with PEF, and COPD-SQ questionnaire combined with PEF for chronic obstructive pulmonary disease (COPD).Methods: This was a cross-sectional study. We distributed self-designed surveys and COPD screening scales (COPD-PS questionnaire and COPD-SQ questionnaire) to residents who underwent physical examination in five community health centers in Haicang District, Xiamen City, from February 2023 to May 2023, and measured their lung function and PEF with a portable device. We used logistic regression to obtain the coefficients of COPD-PS questionnaire, COPD-SQ questionnaire, and PEF, and plotted the receiver operating characteristic curves of each tool for diagnosing COPD and moderate-to-severe COPD. We evaluated and compared the optimal cut-off points and scores of sensitivity, specificity, Youden index, and area under the curve (AUC) values, and assessed the screening efficiency of different methods.Results: Of the 3,537 residents who completed the COPD-SQ questionnaire, COPD-PS questionnaire, and spirometry, 840 were diagnosed with COPD. We obtained the coefficients of COPD-PS questionnaire combined with peak expiratory flow (PEF), and COPD-SQ questionnaire combined with PEF, by logistic regression as −0.479-0.358 × PEF +0.321 × COPD-PS score and − 1.286-0.315 × PEF +0.125 × COPD-SQ score, respectively. The sensitivity of diagnosing COPD by COPD-SQ questionnaire, COPD-PS questionnaire, PEF, COPD-PS questionnaire combined with PEF, and COPD-SQ questionnaire combined with PEF were 0.439, 0.586, 0.519, 0.586, 0.612 respectively, and the specificity were 0.725, 0.621, 0.688, 0.689, 0.663 respectively, with ROC values of 0.606 (95%CI: 0.586–0.626), 0.640 (0.619–0.661), 0.641 (0.619–0.663), 0.678 (0.657–0.699), 0.685 (0.664–0.706) respectively. The sensitivity of diagnosing GOLD II and above by COPD-SQ questionnaire, COPD-PS questionnaire, PEF, COPD-PS questionnaire combined with PEF, and COPD-SQ questionnaire combined with PEF were 0.489, 0.620, 0.665, 0.630, 0.781 respectively, and the specificity were 0.714, 0.603, 0.700, 0.811, 0.629 respectively, with ROC values of 0.631 (95%CI: 0.606–0.655), 0.653 (0.626–0.679), 0.753 (0.730–0.777), 0.784 (0.762–0.806), 0.766 (0.744–0.789) respectively.Conclusion: Our study found that the accuracy of COPD screening by COPD-SQ questionnaire and COPD-PS questionnaire can be improved by combining the results of PEF. The screening performance of COPD-SQ questionnaire combined with PEF is relatively better. In future research, further studies are needed to optimize the performance of screening tools and understand whether their use will affect clinical outcomes.Keywords
All Related Versions
This publication has 22 references indexed in Scilit:
- Screening for impaired pulmonary function using peak expiratory flow: Performance of different interpretation strategiesRespiratory Medicine and Research, 2023
- Discriminative Accuracy of the CAPTURE Tool for Identifying Chronic Obstructive Pulmonary Disease in US Primary Care SettingsJAMA, 2023
- Comparison of peak expiratory Flow(PEF) and COPD assessment test (CAT) to assess COPD exacerbation requiring hospitalization: A prospective observational studyChronic Respiratory Disease, 2022
- Accuracy and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among primary care patients (≥40 years) in China: a cross-sectional screening test accuracy study: findings from the Breathe Well groupBMJ Open, 2021
- Monitoring peak expiratory flow could predict COPD exacerbations: A prospective observational studyRespiratory Medicine, 2019
- A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2017
- Development and Initial Validation of a Self-Scored COPD Population Screener Questionnaire (COPD-PS)COPD: Journal of Chronic Obstructive Pulmonary Disease, 2008
- Lung function testing in the elderly—Can we still use FEV1/FVC<70% as a criterion of COPD?Respiratory Medicine, 2007
- Risk of over-diagnosis of COPD in asymptomatic elderly never-smokersEuropean Respiratory Journal, 2002
- Peak Flow as Predictor of Overall Mortality in Asthma and Chronic Obstructive Pulmonary DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2001