Capnovolumetry in combination with clinical history for the diagnosis of asthma and COPD
| Autor: | Christina Kellerer, K Klütsch, K Husemann, Rudolf A. Jörres, Stephan Sorichter, Antonius Schneider |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty Logistic regression Article Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Respiratory signs and symptoms Internal medicine Chronic obstructive pulmonary disease Asthma Humans Medicine 030212 general & internal medicine Medical History Taking Aged lcsh:RC705-779 COPD medicine.diagnostic_test business.industry Decision Trees Respiratory disease Public Health Environmental and Occupational Health Area under the curve lcsh:Diseases of the respiratory system Carbon Dioxide Middle Aged Airway obstruction medicine.disease CHAID Respiratory Function Tests respiratory tract diseases ddc Logistic Models Breath Tests 030228 respiratory system Female business |
| Zdroj: | NPJ Primary Care Respiratory Medicine npj Primary care respiratory medicine, 30:32 npj Primary Care Respiratory Medicine, Vol 30, Iss 1, Pp 1-9 (2020) |
| Popis: | Capnovolumetry performed during resting ventilation is an easily applicable diagnostic tool sensitive to airway obstruction. In the present analysis, we investigated in which way capnovolumetric parameters can be combined with basic anamnestic information to support the diagnosis of asthma and COPD. Among 1400 patients of a previous diagnostic study, we selected 1057 patients with a diagnosis of asthma (n = 433), COPD (n = 260), or without respiratory disease (n = 364). Besides performing capnovolumetry, patients answered questions on symptoms and smoking status. Logistic regression analysis, single decision trees (CHAID), and ensembles of trees (random forest) were used to identify diagnostic patterns of asthma and COPD. In the random forest approach, area/volume of phase 3, dyspnea upon strong exertion, s3/s2, and current smoking were identified as relevant parameters for COPD vs control. For asthma vs control, they were wheezing, volume of phase 2, current smoking, and dyspnea at strong exertion. For COPD vs asthma, s3/s2 was the primary criterion, followed by current smoking and smoking history. These parameters were also identified as relevant in single decision trees. Regarding the diagnosis of asthma vs control, COPD vs control, and COPD vs asthma, the area under the curve was 0.623, 0.875, and 0.880, respectively, in the random forest approach. Our results indicate that for the diagnosis of asthma and COPD capnovolumetry can be combined with basic anamnestic information in a simple, intuitive, and efficient manner. As capnovolumetry requires less cooperation from the patient than spirometry, this approach might be helpful for clinical practice. |
| Databáze: | OpenAIRE |
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