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[Pack-years threshold and HAS self-questionnaire for COPD early diagnosis]
M Lorenzo1, S Delpeyroux2, V Dupre1
1Département de médecine générale, UFR de médecine, université de Strasbourg, Strasbourg, France; Maison de santé pluriprofessionnelle Guillaume Tell, 2, place Guillaume-Tell, 68100 Mulhouse, France.
Introduction:
The Haute Autorité de santé (HAS) in France offers a patient self-questionnaire to optimize targeted chronic obstructive pulmonary disease (COPD) screening among at-risk patients in primary care. It includes smoking but does not have a threshold for pack-years (PY) smoked. The objective of this study was to compare the positive predictive values (PPV) of the HAS self-questionnaire alone and with the addition of a PY threshold.
Methods:
This was a prospective pilot study conducted in a multi-professional health centre. Identification among smoking or former smoking patients without a COPD diagnosis of subjects with a positive HAS self-questionnaire, a positive PY threshold, or both. We performed spirometry after bronchodilatation.
Results:
Thirty-five people were included in the study. All 35 had a positive PY threshold. The HAS questionnaire was positive for 22 of them (62.9%). Spirometry diagnosed 18 participants with COPD (51%). The PPV for the HAS questionnaire was 0.41 and the PPV for the HAS+PY questionnaire was 0.51. There was no statistically significant difference between these two PPVs (P=0.3692).
Conclusions:
The addition of a PY threshold to the HAS self-questionnaire may allow better targeting of the population at risk of developing COPD.
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