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Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care?

Authors Kjeldgaard P, Lykkegaard J, Spillemose H, Ulrik CS

Received 6 March 2017

Accepted for publication 5 July 2017

Published 4 August 2017 Volume 2017:12 Pages 2323—2331

DOI https://doi.org/10.2147/COPD.S136244

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Peter Kjeldgaard,1 Jesper Lykkegaard,2 Heidi Spillemose,3 Charlotte Suppli Ulrik1,4

1Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, 2Research Unit of General Practice, University of Southern Denmark, Odense, 3General Practice Aarup Lægerne, Aarup, 4Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Background and aim: Early detection of COPD may reduce the future burden of the disease. We aimed to investigate whether prescreening with a COPD-6 screening device (measuring FEV1 and FEV6) facilitates early detection of COPD in primary care.
Methods: In primary care, individuals at high risk of COPD (ie, age ≥35 years, relevant exposure, and at least one respiratory symptom) and no previous diagnosis of obstructive lung disease were examined with a COPD-6 screening device. In prioritized order, the criteria for proceeding to confirmatory spirometry were FEV1/FEV6 <0.7, FEV1 <80%pred, or clinical suspicion of COPD regardless of test result (medical doctor’s [MD] decision). Based on spirometry, including bronchodilator (BD) reversibility test, individuals were classified as COPD (post-BD FEV1/FVC <0.70), asthma (ΔFEV1 ≥0.50 L), or no obstructive lung disease.
Results: A total of 2,990 subjects (54% men, mean age 59 years, and mean 28 pack-years) were enrolled, of whom 949 (32%) proceeded from COPD-6 screening to confirmative spirometry based on the following criteria: 510 (54%) FEV1/FEV6 <0.70, 382 (40%) FEV1 <80%pred, and 57 (6%) MD decision. Following confirmative spirometry, the 949 individuals were diagnosed as having COPD (51%), asthma (3%), and no obstructive lung disease (45%). COPD was diagnosed in 487 (16%) of the enrolled subjects in whom confirmative spirometry was performed in 69% based on FEV1/FEV6 <0.7 and in 29% based on FEV1 ≤80%pred.
Conclusion: Prescreening with the COPD-6 device showed acceptable specificity for the selection of subjects for diagnostic spirometry and is likely to be a useful alternative to current practice in primary care.

Keywords: early COPD, diagnosis, spirometry, general practice
 

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