VitalQPlus: a potential screening tool for early diagnosis of COPD

Sui, Chee Fai; Ming, Long Chiau; Neoh, Chin Fen; Ibrahim, Baharudin

doi:10.2147/copd.s84618

Cited by 9 publications

(4 citation statements)

References 38 publications

(64 reference statements)

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“…Studies have demonstrated that a dual-combination assessment tool, namely VitalQPlus, which incorporates the COPD-PS questionnaire and the COPD-6 screener with an FEV1/FEV6 ratio of <75%, could be used by physicians to identify individuals at risk of COPD and to select patients for conventional spirometry. 29 This observation is similar to that in a meta-analysis; the authors of that meta-analysis suggested using a questionnaire as a prescreening test for microspirometry to improve COPD screening accuracy. 12 However, the prescreen use of a COPD-PS questionnaire followed by microspirometry with FEV1/FVC ratio calculations has not been validated and requires further investigation.…”

Section: Discussionsupporting

confidence: 73%

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

Chen¹,

Sheu²,

Cheng³

et al. 2021

COPD

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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.

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Section: Discussionsupporting

confidence: 73%

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

Chen¹,

Sheu²,

Cheng³

et al. 2021

COPD

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“…For example, Soriano et al reported that the combination of COPD-PS and peak expiratory flow (PEF) measurements at recommended thresholds in primary care is a useful, reliable strategy for finding new COPD cases, leading to a 90% reduction in the number of spirometry tests performed [ 24 ]. COPD-PS combined with COPD-6 could potentially be used by clinicians to identify individuals at risk of COPD and to select patients for spirometry measurement [ 26 ]. Thus, we suggest that COPD-PS should be used with other tools, which may substantially reduce the number of unnecessary spirometry tests.…”

Section: Discussionmentioning

confidence: 99%

Performance of COPD population screener questionnaire in COPD screening: a validation study and meta-analysis

Zhang

Qian

et al. 2021

Annals of Medicine

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This study aimed to validate the chronic obstructive pulmonary disease (COPD) Population Screener (COPD-PS) questionnaire as a screening tool in a cohort of Chinese subjects who underwent a health examination, and to summarise its overall performance through a meta-analysis. We enrolled 997 subjects aged !40 years who underwent a health examination, both lung function and COPD-PS data were collected. The screening performance of COPD-PS was evaluated with a receiver operating characteristic (ROC) curve analysis, using the area under the curve (AUC) to assess the screening accuracy. A standard diagnostic meta-analysis was used to summarise the screening performance of COPD-PS for COPD. Of the 997 subjects, 157 were identified as having COPD. The COPD-PS score was significantly higher in COPD patients than controls (5.03 ± 5.11 vs. 2.72 ± 1.80, p < .001). At a cut-off of 4, the sensitivity and specificity of COPD-PS for identifying COPD were 74.52 and 70.24%, respectively, with an AUC of 0.79. Eight studies (including this study) were included in this meta-analysis. The pooled estimates for COPD-PS were as follows: sensitivity of 0.66 (95% CI: 0.47-0.63), specificity of 0.86 (95% CI: 0.84-0.89), positive likelihood ratio of 3.00 (95% CI: 1.65-5.47), negative likelihood ratio of 0.43 (95% CI: 0.35-0.52) and diagnostic odds ratio of 7.24 (95% CI: 3.91-13.40). The AUC of the summary ROC curve was 0.78. COPD-PS appears to be a useful tool for screening individuals with a high risk of COPD and guiding the selection of individuals for subsequent spirometry examination. KEY MESSAGESCOPD-PS is a simple and useful method to screen COPD. The combination of COPD-PS with other tools may improve the screen performance.

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“…There is a consensus in literature about the great importance of early COPD diagnosis, enabling the establishment of measures that may alter the course of the disease, including pharmacological and non-pharmacological interventions and smoking cessation. 7 – 11 Assessment of respiratory obstruction in the early stages is critically dependent on the sensitivity of pulmonary function tests. 12 It has previously been observed that spirometric indices are not sensitive to small changes due to smoking.…”

Section: Introductionmentioning

confidence: 99%

Forced oscillation technique for early detection of the effects of smoking and COPD: contribution of fractional-order modeling

Ribeiro¹,

Faria²,

Lopes³

et al. 2018

COPD

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PurposeThe aim of the present study was to evaluate the performance of the forced oscillation technique (FOT) for the early diagnosis of the effects of smoking and COPD. The contributions of the integer-order (InOr) and fractional-order (FrOr) models were also evaluated.Patients and methodsIn total, 120 subjects were analyzed: 40 controls, 40 smokers (20.3±9.3 pack-years) and 40 patients with mild COPD.ResultsInitially, it was observed that traditional FOT parameters and the InOr and FrOr models provided a consistent description of the COPD pathophysiology. Mild COPD introduced significant increases in the FrOr inertance, damping factor and hysteresivity (P<0.0001). These parameters were significantly correlated with the spirometric parameters of central and small airway obstruction (P<0.0001). The diagnostic accuracy analyses indicated that FOT parameters and InOr modeling may adequately identify these changes (area under the receiver operating characteristic curve – AUC >0.8). The use of FrOr modeling significantly improved this process (P<0.05), allowing the early diagnosis of smokers and patients with mild COPD with high accuracy (AUC >0.9).ConclusionFrOr modeling improves our knowledge of modifications that occur in the early stages of COPD. Additionally, the findings of the present study provide evidence that these models may play an important role in the early diagnosis of COPD, which is crucial for improving the clinical management of the disease.

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VitalQPlus: a potential screening tool for early diagnosis of COPD

Cited by 9 publications

References 38 publications

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

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

Performance of COPD population screener questionnaire in COPD screening: a validation study and meta-analysis

Forced oscillation technique for early detection of the effects of smoking and COPD: contribution of fractional-order modeling

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