Symptom-based questionnaire for differentiating COPD and asthma.

Many patients with obstructive lung disease (OLD) carry an inaccurate diagnostic label. Symptom-based questionnaires could identify persons likely to need spirometry. We prospectively tested questions derived from a comprehensive literature review and an international Delphi panel to help identify chronic OLD (COPD) in persons with prior evidence of OLD. Subjects were recruited via random mailing to primary-care practices in Aberdeen, Scotland, and Denver, Colorado. Persons aged 40 and older reporting any prior diagnosis of OLD or any respiratory medications in the past year were enrolled. Participants answered 54 questions covering demographics and symptoms and underwent spirometry with reversibility testing. A study diagnosis of COPD was defined by fixed airway obstruction as measured by post-bronchodilator FEV(1)/FVC <0.70. We examined ability of individual questions in a multivariate framework to discriminate between persons with and without the study diagnosis of COPD. 597 persons completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analyses, which was reduced to 19 items for entry into a multivariate regression model. Nine items had significant relationships with the study diagnosis of COPD, including increased age, pack-years, worsening cough, breathing-related disability or hospitalization, worsening dyspnea, phlegm quantity, cold going to the chest, and receipt of treatment for breathing. Individual items yielded odds ratios ranging from 0.33 to 20.7. This questionnaire demonstrated a sensitivity of 72.0 and a specificity of 82.7. A short, symptom-based questionnaire identifies persons more likely to have COPD among persons with prior evidence of OLD.

Tinkelman DG ，Price DB ，Nordyke RJ ，Halbert RJ ，Isonaka S ，Nonikov D ，Juniper EF ，Freeman D ，Hausen T ，Levy ML ，Ostrem A ，van der Molen T ，van Schayck CP ... -  《RESPIRATION》

Symptom-based questionnaire for identifying COPD in smokers.

Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care. We prospectively tested questions to help identify COPD among smokers without prior history of lung disease. Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo., USA. Current and former smokers aged 40 or older with no prior respiratory diagnosis and no respiratory medications in the past year were enrolled. Participants answered questions covering demographics and symptoms and then underwent spirometry with reversibility testing. A study diagnosis of COPD was defined as fixed airway obstruction as measured by post-bronchodilator FEV(1)/FVC <0.70. We examined the ability of individual questions in a multivariate framework to correctly discriminate between persons with and without COPD. 818 subjects completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analysis, which was reduced to 17 items for entry into multivariate regression. Eight items had significant relationships with the study diagnosis of COPD, including age, pack-years, body mass index, weather-affected cough, phlegm without a cold, morning phlegm, wheeze frequency, and history of any allergies. Individual items yielded odds ratios ranging from 0.23 to 12. This questionnaire demonstrated a sensitivity of 80.4 and specificity of 72.0. A simple patient self-administered questionnaire can be used to identify patients with a high likelihood of having COPD, for whom spirometric testing is particularly important. Implementation of this questionnaire could enhance the efficiency and diagnostic accuracy of current screening efforts.

Price DB ，Tinkelman DG ，Halbert RJ ，Nordyke RJ ，Isonaka S ，Nonikov D ，Juniper EF ，Freeman D ，Hausen T ，Levy ML ，Ostrem A ，van der Molen T ，van Schayck CP ... -  《-》

Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over.

Tinkelman DG ，Price DB ，Nordyke RJ ，Halbert RJ ... -  《JOURNAL OF ASTHMA》

Comparison of existing symptom-based questionnaires for identifying COPD in the general practice setting.

van Schayck CP ，Halbert RJ ，Nordyke RJ ，Isonaka S ，Maroni J ，Nonikov D ... -  《-》

Development of a population-based screening questionnaire for COPD.

Calverley PM ，Nordyke RJ ，Halbert RJ ，Isonaka S ，Nonikov D ... -  《-》