Literature DB >> 16330874

Symptom-based questionnaire for differentiating COPD and asthma.

David G Tinkelman1, David B Price, Robert J Nordyke, R J Halbert, Sharon Isonaka, Dmitry Nonikov, Elizabeth F Juniper, Daryl Freeman, Thomas Hausen, Mark L Levy, Anders Ostrem, Thys van der Molen, Constant P van Schayck.   

Abstract

BACKGROUND: Many patients with obstructive lung disease (OLD) carry an inaccurate diagnostic label. Symptom-based questionnaires could identify persons likely to need spirometry.
OBJECTIVES: We prospectively tested questions derived from a comprehensive literature review and an international Delphi panel to help identify chronic OLD (COPD) in persons with prior evidence of OLD.
METHODS: Subjects were recruited via random mailing to primary-care practices in Aberdeen, Scotland, and Denver, Colorado. Persons aged 40 and older reporting any prior diagnosis of OLD or any respiratory medications in the past year were enrolled. Participants answered 54 questions covering demographics and symptoms and underwent spirometry with reversibility testing. A study diagnosis of COPD was defined by fixed airway obstruction as measured by post-bronchodilator FEV(1)/FVC <0.70. We examined ability of individual questions in a multivariate framework to discriminate between persons with and without the study diagnosis of COPD.
RESULTS: 597 persons completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analyses, which was reduced to 19 items for entry into a multivariate regression model. Nine items had significant relationships with the study diagnosis of COPD, including increased age, pack-years, worsening cough, breathing-related disability or hospitalization, worsening dyspnea, phlegm quantity, cold going to the chest, and receipt of treatment for breathing. Individual items yielded odds ratios ranging from 0.33 to 20.7. This questionnaire demonstrated a sensitivity of 72.0 and a specificity of 82.7.
CONCLUSIONS: A short, symptom-based questionnaire identifies persons more likely to have COPD among persons with prior evidence of OLD. Copyright (c) 2006 S. Karger AG, Basel.

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Year:  2005        PMID: 16330874     DOI: 10.1159/000090141

Source DB:  PubMed          Journal:  Respiration        ISSN: 0025-7931            Impact factor:   3.580


  21 in total

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Review 3.  Improving the differential diagnosis of chronic obstructive pulmonary disease in primary care.

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9.  Trigger factors in asthma and chronic obstructive pulmonary disease: a single-centre cross-sectional survey.

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10.  Insight into Best Variables for COPD Case Identification: A Random Forests Analysis.

Authors:  Nancy K Leidy; Karen G Malley; Anna W Steenrod; David M Mannino; Barry J Make; Russ P Bowler; Byron M Thomashow; R G Barr; Stephen I Rennard; Julia F Houfek; Barbara P Yawn; Meilan K Han; Catherine A Meldrum; Elizabeth D Bacci; John W Walsh; Fernando Martinez
Journal:  Chronic Obstr Pulm Dis       Date:  2016
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