Questions for COPD diagnostic screening in a primary care setting
| Autor: | Dmitry Nonikov, Sharon Isonaka, Daryl Freeman, Jaman Maroni, Ronald J. Halbert, David Price, Robert J. Nordyke |
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| Rok vydání: | 2005 |
| Předmět: |
Spirometry
Questionnaires Adult Male Pulmonary and Respiratory Medicine medicine.medical_specialty Sensitivity and Specificity Pulmonary Disease Chronic Obstructive Predictive Value of Tests Wheeze Internal medicine Surveys and Questionnaires medicine Humans Mass Screening Family history Mass screening Asthma Aged COPD medicine.diagnostic_test Primary Health Care business.industry Chronic obstructive pulmonary disease Middle Aged medicine.disease Primary care Obstructive lung disease respiratory tract diseases Predictive value of tests Physical therapy Female medicine.symptom business Family Practice |
| Zdroj: | Respiratory Medicine. 99(10):1311-1318 |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2005.02.037 |
| Popis: | Summary Objectives To test questions usable in an ambulatory clinic to identify persons likely to have chronic obstructive pulmonary disease (COPD). Methods Analyses were performed as part of a study to identify patients with likely COPD in the Glenfield UK primary care clinic. Patients age 40 and older were recruited based on one of the following criteria: (1) respiratory medications in previous 2 years; (2) history of smoking or (3) history of asthma with no current medications based on case notes. Consenting patients reported smoking history, symptoms, and personal and family history of respiratory conditions. Spirometry with reversibility was conducted to ATS standards. Analyses were performed on this database to test questions for identifying patients with COPD from a sample of patients with a positive smoking history. Multivariate logistic regression identified the question set that best discriminated COPD from other conditions using receiver operating characteristic curves. The usefulness of a simple scoring system was assessed. Results The study sample included 369 current and former smokers. Patients were diagnosed as: COPD = 62 (16.8%); asthma = 30 (8.1%); or no obstructive lung disease = 277 (75.1%). The best questions for discriminating between persons with and without COPD included items on age, dyspnoea on exertion, and wheeze. This set of questions identified COPD patients with a sensitivity of 77.4–87.1% and specificity of 71.3–76.2%. Conclusions A simple questionnaire can facilitate the diagnosis of COPD in a primary care setting. |
| Databáze: | OpenAIRE |
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