CAPTURE and PUMA as Case-Finding Tools in Patients at Risk of COPD-A Multicenter Mexican Experience

Area of Science:

• Pulmonology
• Epidemiology
• Public Health

Background:

• Chronic obstructive pulmonary disease (COPD) poses a significant global health burden.
• Underdiagnosis is prevalent in low- and middle-income countries due to limited spirometry access.
• Effective case-finding strategies are needed for routine clinical practice.

Purpose of the Study:

• To compare the effectiveness of PUMA and CAPTURE questionnaires for COPD screening in Mexican adults.
• To evaluate the sensitivity and specificity of these questionnaires in identifying spirometric obstructive patterns.
• To assess the correlation of questionnaire scores with FEV1/FVC ratios.

Main Methods:

• A multicenter, cross-sectional study involving COPD screening campaigns.
• Adults over 40 with risk factors (smoking, biomass exposure) were enrolled.
• COPD diagnosis confirmed by post-bronchodilator FEV1/FVC < 0.70; sensitivity, specificity, and ROC curves analyzed.

Main Results:

• COPD was diagnosed in 37.1% of 197 participants.
• PUMA questionnaire achieved 74.0% sensitivity and 51.6% specificity (cut-off ≥6).
• CAPTURE questionnaire showed varying results: ≥3 (76.9% sensitivity, 40.9% specificity) or ≥4 (61.5% sensitivity, 72.7% specificity).
• Both questionnaires demonstrated moderate accuracy (ROC 0.693 for PUMA, 0.714 for CAPTURE) and significant negative correlations with FEV1/FVC.

Conclusions:

• PUMA and CAPTURE questionnaires offer moderate certainty for diagnosing patients at risk of COPD with spirometric obstruction in Mexican populations.
• These tools can aid in identifying at-risk individuals in primary care settings.
• Further validation in diverse populations is warranted.