Performance and Clinical Utility of Various Chronic Obstructive Pulmonary Disease Case-Finding Tools

Abstract

Background and Aim Chronic obstructive pulmonary disease (COPD) is frequently underdiagnosed because of the unavailability of spirometers, especially in resource-limited outpatient settings. This study provides real-world evidence to identify optimal approaches for COPD case finding in outpatient settings. Methods This retrospective study enrolled individuals who were at risk of COPD (age ≥40 years, ≥10 pack-years, and ≥1 respiratory symptom). Eligible participants were examined using various COPD case-finding tools, namely the COPD Population Screener (COPD-PS) questionnaire, a COPD prediction (P COPD ) model, and a microspirometer, Spirobank Smart; subsequently, the participants underwent confirmatory spirometry. The definition and confirmation of COPD were based on conventional spirometry. Receiver operating characteristic curve (ROC), area under the curve (AUC), and decision curve analyses were conducted, and a clinical impact curve was constructed. Results In total, 385 participants took part in the study [284 without COPD (73.77%) and 101 with COPD (26.23%)]. The microspirometer exhibited a higher AUC value than did the COPD-PS questionnaire and the P COPD model. The AUC for microspirometry was 0.908 (95% confidence interval [CI] = 0.87–0.95), that for the P COPD model was 0.788 (95% CI = 0.74–0.84), and that for the COPD-PS questionnaire was 0.726 (95% CI = 0.67–0.78). Decision and clinical impact curve analyses revealed that a microspirometry-derived FEV1/FVC ratio of <74% had superior clinical utility to the other measurement tools. Conclusion The P COPD model and COPD-PS questionnaire were useful for identifying symptomatic patients likely to have COPD, but microspirometry was more accurate and had higher clinical utility. This study provides real-world evidence to identify optimal practices for COPD case finding; such practices ensure that physicians have convenient access to up-to-date evidence when they encounter a symptomatic patient likely to have COPD.

Current Progress of COPD Early Detection: Key Points and Novel Strategies

“… 6 Chen et al provided real-world evidence by comparing Spirobank Smart, a novel app-based spirometer, with the P COPD and COPD-PS. The results demonstrated that Spirobank Smart (AUC = 0.908) exhibited higher accuracy, sensitivity, and specificity than did the P COPD (AUC = 0.788) and COPD-PS (AUC = 0.726) in identifying those with COPD; 63 this finding is consistent with that of the meta-analysis. This study compares the discriminative accuracy of combination methods, including CATURE, and COLA in 3 low- and middle-income country settings (including Nepal, Peru, and Uganda).…”

Combination Effect Among Giving Tripod Position and Pursed Lip Breathing to Respiration Rate in Chronic Obstructive Pulmonary Disease (Copd) Patients

“…Emphysema slowly destroys the air sacs in the lungs, which interferes with the flow of air out while, bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up. Both conditions cause obstruction of airflow in the respiratory system and cause breathing problems (Chen et al, 2021). COPD patients will experience shortness of breath so that they experience an increase in external respiratory frequency (De Miguel-Díez et al, 2019).…”