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Validation of smoking cessation self-reported by patients with chronic obstructive pulmonary disease

Authors Hilberink S, Jacobs JE, Van Opstal S, Van der Weijden T, Janine Keegstra, Kempers P, Muris JW, Grol R, De Vries H

Published 23 January 2011 Volume 2011:4 Pages 85—90


Review by Single anonymous peer review

Peer reviewer comments 4

Sander R Hilberink1, Johanna E Jacobs1, Sanne van Opstal2, Trudy van der Weijden2, Janine Keegstra1, Pascal LJ Kempers3, Jean WM Muris2, Richard PTM Grol1, Hein de Vries4
1IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 2Department of General Practice, Maastricht University, Research Institute CAPHRI, Maastricht, The Netherlands; 3Department of Health Risk, Analysis and Toxicology, 4Department of Health Promotion and Health, Maastricht University, Maastricht, The Netherlands

Purpose: The present study reports on the biochemical validation of the self-reported smoking status of patients with chronic obstructive pulmonary disease (COPD). The objective is to establish the proportion of overestimation of self-reported success rates.
Methods: A cross-sectional smoking-status validation study including 60 patients with COPD who reported that they had stopped smoking. In the analysis of urine samples, a cut-off point of 50 ng/mL of cotinine was used.
Results: At the time of biochemical validation, 55 patients reported that they had quit smoking while five patients resumed smoking. Smoking status was biochemically confirmed for 43 patients (78%) and 12 patients (22%) were classified as smokers. The sensitivity of the self-report of smoking was 29% and the specificity was 100%.
Conclusion: Many primary care patients with COPD do not provide valid information on their smoking status, which hamper adequate therapeutic interventions. Integration of biochemical validation in daily care could overcome this problem, but may harm the doctor–patient relationship.

Keywords: chronic obstructive pulmonary disease, smoking cessation, biochemical validation, general practice, outcome measurement

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