PURPOSE The purpose of this study was to evaluate sensitivity, specificity, and positive and negative likelihood ratios of laryngeal height, lung function, and diagnostic questionnaires for screening and diagnosis of chronic obstructive pulmonary disease (COPD). METHODSWe undertook a cross-sectional study of 233 people aged between 40 and 75 years. Measured variables were age, sex, weight, height, body mass index, tobacco use, maximum laryngeal height, and spirometry, and we administered a COPD questionnaire and the Lung Function Questionnaire.RESULTS For laryngeal height, we found a positive likelihood ratio of 5.21, and for the Lung Function Questionnaire, we found a negative likelihood ratio of 0.10. Combining a maximum laryngeal height of ≤4 cm with Lung Function Questionnaire findings of ≤18 yielded a positive likelihood ratio of 29.06, and a negative likelihood ratio of 0.26. CONCLUSIONSThe intrinsic validity of the lung function questionnaire makes it useful for screening. Combining Lung Function Questionnaire results and laryngeal height can help confirm or dismiss COPD. INTRODUCTIONI n addition to having a major socioeconomic impact, 1 chronic obstructive pulmonary disease (COPD) is associated with high morbidity and high mortality. Various symptoms and exploratory signs of COPD have been studied, 2,3 but findings from a physical examination are rarely diagnostic. 4 Questionnaires, such as a COPD diagnostic questionnaire 5,6 (which addresses allergies and lower respiratory track symptoms, as well as cough, age, smoking pack-year, body mass index) and the Lung Function Questionnaire 7 (which addresses age, smoking history, frequency of productive cough, chest sounds, and breathing difficulty during physical activity), have been proposed to select individuals for spirometry because of their validity and simple application in family medicine practice. In 2000 laryngeal height began to be evaluated as a diagnostic sign 8 without much continuity. 9 Because sternal elevation produced by the thoracic hyperinsufflation found in this disease is thought to decrease laryngeal and tracheal heights, laryngeal height, tracheal height, and laryngeal descent are also thought to be diagnostic signs of COPD.Although the validity of examinations that facilitate screening and diagnosis has demonstrated their usefulness, research on exploratory tests is scarce. Our objective was to evaluate the sensitivity, specificity, and positive and negative likelihood ratios of maximum laryngeal height, the Lung Function Questionnaire, and the COPD diagnostic questionnaire for screening and diagnosis in a primary health care population. For this study, we used the maximum laryngeal height, measured from the suprasternal notch to the top of thyroid cartilage at the end of an expiration, as proposed by Strauss and colleagues. 8,9 Verónica Casado, MD METHODSA cross-sectional investigational study was conducted using a random sampling of a general population aged between 40 to 75 years in a basic health area of 26,108 inhabitant...
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