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Comparison of existing symptom-based questionnaires for identifying COPD in the general practice setting
Constant P van Schayck1, Ronald J Halbert, Robert J Nordyke
1Department of General Practice, Research Institute Caphri, University of Maastricht, Maastricht, Netherlands.
Respirology (Carlton, Vic.)
|June 16, 2005
Summary
Simple questionnaires can help identify individuals needing spirometry for diagnosing chronic obstructive pulmonary disease (COPD). Key factors include age, BMI, smoking history, and specific symptoms like cough and breathlessness.
Area of Science:
- Pulmonary Medicine
- Diagnostic Tools
- Epidemiology
Background:
- Chronic Obstructive Pulmonary Disease (COPD) is frequently underdiagnosed, partly due to underutilization of spirometry.
- Symptom-based questionnaires can serve as a valuable adjunct to spirometry in clinical practice.
Purpose of the Study:
- To identify specific question types that can aid in the identification of COPD.
- To evaluate the utility of questionnaires in both case-finding and differential diagnosis scenarios for COPD.
Main Methods:
- A literature review and expert consultation identified relevant questionnaires.
- Questions were grouped and retrospectively validated using the Third National Health and Nutrition Examination Survey data.
- Bivariate and multivariate analyses examined the predictive ability of various question types.
Main Results:
- Most question types showed significant bivariate relationships with airway obstruction.
- Multivariate analysis identified age, BMI, smoking status (including pack-years), symptoms (cough, phlegm, dyspnea, wheeze), and prior diagnoses as significant discriminators.
- Demographic, personal history, and smoking information were key components.
Conclusions:
- Simple, self-administered questionnaires can effectively identify individuals who would benefit from spirometric testing for COPD.
- Further research, including prospective validation and policy development, is needed for optimal implementation of these tools.