Journal Article

Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings

Priegue-Carrera, Ana, Represas-Represas, Cristina, Ruano-Raviña, Alberto, Botana-Rial, Maribel, Fernández-Villar, Alberto

2016

Overview

The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings. Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh). individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis. 437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performance in the different settings and also regarding age, gender and smoking status. The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Airway management / At risk populations / Bronchodilators / Care and treatment / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Diagnosis / Diagnostic systems / Drug stores / Emergency medical services / Female / Health care / Health care reform / Health screening / Hospitals / Humans / Lung diseases / Male / Management / Medical care / Medical diagnosis / Middle Aged / Obstructive lung disease / Pharmacists / Population studies / Portable equipment / Preventive medicine / Primary care / Prospective Studies / Pulmonary Disease, Chronic Obstructive - diagnosis / Reliability analysis / Reproducibility of Results / Respiratory diseases / Risk analysis / Risk factors / Screening / Smoking / Spirometers / Taiwan / Thoracic surgery / Validity