A Brief and Effective Questionnaire for COPD Screening in High-Altitude Areas

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Public Health

Background:

• High-altitude living presents unique challenges for respiratory health.
• Chronic Obstructive Pulmonary Disease (COPD) prevalence and risk factors may differ at high altitudes.
• Effective screening tools are needed for primary healthcare in these specific environments.

Purpose of the Study:

• To develop and validate a reliable screening questionnaire for COPD.
• To adapt screening for primary healthcare institutions in high-altitude regions.

Main Methods:

• A large cross-sectional study involved 2909 individuals residing above 2100 meters (aged ≥35).
• Data were split into development (70%) and validation (30%) sets.
• Logistic regression identified key variables (age, TB history, smoking, pollution, CAT score) for a scoring system; ROC analysis evaluated performance.

Main Results:

• Five variables significantly correlated with COPD: age, pulmonary tuberculosis history, smoking, household air pollution, and COPD Assessment Test (CAT) score.
• The developed scoring system achieved an Area Under the Curve (AUC) of 0.714 (development) and 0.726 (validation).
• An optimal cutoff score of 22 yielded 85.0% sensitivity and 48.4% specificity, with performance varying by altitude.

Conclusions:

• The developed COPD screening questionnaire is effective for high-altitude primary healthcare settings.
• This tool can aid in the early identification of COPD in populations living at high altitudes.
• Further validation across diverse high-altitude populations may enhance its utility.