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Symptom-based questionnaire for differentiating COPD and asthma.

David G Tinkelman1, David B Price, Robert J Nordyke

  • 1National Jewish Medical and Research Center, Denver, Colo., USA.

Respiration; International Review of Thoracic Diseases
|December 7, 2005
PubMed
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A symptom questionnaire can identify individuals with obstructive lung disease (OLD) who may have chronic obstructive pulmonary disease (COPD). This tool helps target patients needing further spirometry testing.

Area of Science:

  • Pulmonary Medicine
  • Diagnostic Tools
  • Epidemiology

Background:

  • Many patients with obstructive lung disease (OLD) are misdiagnosed.
  • Symptom assessment tools can aid in identifying individuals who require spirometry.

Purpose of the Study:

  • To prospectively evaluate symptom-based questions for identifying chronic obstructive pulmonary disease (COPD) in patients with existing OLD diagnoses.
  • To refine diagnostic criteria using a Delphi panel and literature review.

Main Methods:

  • Recruited 597 participants aged 40+ from primary care with prior OLD diagnosis or medication use.
  • Administered a 54-question survey on symptoms and demographics.
  • Performed spirometry to define COPD (post-bronchodilator FEV1/FVC <0.70) and analyzed question discrimination.

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Main Results:

  • Nine key symptoms and factors significantly predicted COPD diagnosis.
  • These included age, pack-years, cough, dyspnea, phlegm, and respiratory disability/hospitalization.
  • The questionnaire achieved 72.0% sensitivity and 82.7% specificity for COPD detection.

Conclusions:

  • A concise, symptom-focused questionnaire effectively identifies individuals with a higher likelihood of COPD among those with pre-existing OLD.
  • This tool can improve the efficiency of diagnosing COPD in primary care settings.