Alirio R Bastidas, Eduardo Tuta-Quintero, José S Arias, Diana Cufiño, Diana Moya, Daniel Martin, Faure Rodríguez, Carolina Aponte-Murcia, Doris M Pumarejo, Maria A Bejarano, Geraldine Ospina, Lina M Morales, Adriana M Portella, Maria D Barragán, Daniela A Álvarez, José M Hernández
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引用次数: 0
Abstract
Background: Chronic obstructive pulmonary disease (COPD) remains one of the most prevalent pathologies in the world and is among the leading causes of mortality and morbidity, partially due to underdiagnosis. The use of clinical questionnaires to identify high-risk individuals to take them to further diagnostic procedures has emerged as a strategy to address this problem.
Objective: To compare the performance of the COULD IT BE COPD, CDQ, COPD-PS, LFQ, and PUMA questionnaires for COPD diagnosis.
Methods: A cross-sectional study was carried out on subjects who underwent spirometry in the third-level center. Data were collected between January 2015 and March 2020. Bivariate analysis was performed between the study variables and the presence of COPD. The area under the receiver operating characteristics curve (AUC-ROC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) for each questionnaire were calculated. The AUC-ROCs were compared with the DeLong test, considering a p value <0.05 statistically significant.
Results: 681 subjects met the inclusion criteria and were taken to the final analysis. The prevalence of COPD was 27.5% (187/681). The mean age of the subjects was 65.9 years (SD ± 11.79); 46.3% (315/681) were female, and 83.6% (569/681) reported respiratory symptoms. Statistically significant relationship was found for COPD diagnosis with male sex, older age, respiratory symptoms, and exposure to wood smoke (p value <0.05). The AUC-ROCs of the questionnaires were between 0.581 and 0.681. The COULD IT BE COPD questionnaire had a lower discriminatory capacity AUC-ROC of 0.581, concerning the other scores (DeLong test, p = 0.0002).
Conclusion: The CDQ, COPD-PS, LFQ, PUMA, and COULD IT BE COPD questionnaires have acceptable performance for the diagnosis of COPD together with low sensitivity and specificity. Therefore, its use must be complemented with other diagnostic tests or techniques such as pulmonary function tests.
背景:慢性阻塞性肺疾病(COPD)仍然是世界上最普遍的疾病之一,也是导致死亡率和发病率的主要原因之一,部分原因是诊断不足。使用临床问卷来确定高风险个体,并将其带入进一步的诊断程序,已成为解决这一问题的一种策略。目的:比较COULD IT BE COPD、CDQ、COPD- ps、LFQ和PUMA问卷在COPD诊断中的表现。方法:对在三级中心接受肺活量测定的受试者进行横断面研究。数据收集于2015年1月至2020年3月。在研究变量与COPD存在之间进行双变量分析。计算各问卷的受试者工作特征曲线下面积(AUC-ROC)、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)、阳性似然比(LR+)、阴性似然比(LR-)。将auc - roc与DeLong检验进行比较,考虑p值。结果:681名受试者符合纳入标准,并进行最终分析。COPD患病率为27.5%(187/681)。受试者平均年龄为65.9岁(SD±11.79);46.3%(315/681)为女性,83.6%(569/681)报告呼吸道症状。COPD诊断与男性、年龄、呼吸系统症状和木材烟雾暴露有统计学意义(p值p = 0.0002)。结论:CDQ、COPD- ps、LFQ、PUMA、COULD IT BE COPD问卷对COPD的诊断性能尚可,但敏感性和特异性较低。因此,它的使用必须辅以其他诊断测试或技术,如肺功能测试。
期刊介绍:
Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.