Arzu Balkan1, Yonca Bulut2, Carl R Fuhrman3, Stephen N Fisher3, David O Wilson4, Joel L Weissfeld5, Frank C Sciurba4. 1. Department of Medical Education, Baskent University Faculty of Medicine, Ankara, Turkey. 2. Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. 3. Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 4. Department of Pulmonary and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 5. Department of Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Abstract
BACKGROUND AND AIMS: COPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic categorization of a high-risk population has many potential benefits. The present study uses a symptom questionnaire, low-dose computed tomography (LDCT) and pulmonary function tests (PFT) to phenotypically subgroup a high-risk population. METHODS: Study group consisted of current or former smokers who underwent lung cancer screening with LDCT as a subgroup of Pittsburgh Lung Screening Study. In addition to LDCT, PFT and a symptom query questionnaire were obtained from each patient. RESULTS: The study group consisted of 3183 subjects (age 50-79) subdivided into eight groups according to presence of symptoms, obstruction on PFT and presence of emphysema on LDCT. A total of 501 (15.7%) subjects were asymptomatic, with no airflow obstruction or evidence of emphysema. There were 866 (27.2%) subjects with both obstruction on PFT and emphysema on LDCT, but only 660 (20.7%) had symptoms. Five hundred thirty (16.6%) of the subjects had no emphysema on LDCT but had obstruction on PFT, although only 370 (11.6%) had symptoms. Four hundred seventy-four (14.9%) of subjects had emphysema on LDCT, but no airflow obstruction, with 312 (9.8%) symptomatic. Finally, 812 (25.5%) of subjects had no evidence of airflow obstruction on PFT or emphysema on LDCT, but had symptoms. CONCLUSION: Combining LDCT with PFT and a comprehensive questionnaire allows subgroup classification of COPD phenotypes in a high-risk population and may lead to earlier intervention and an improved framework for future studies.
BACKGROUND AND AIMS: COPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic categorization of a high-risk population has many potential benefits. The present study uses a symptom questionnaire, low-dose computed tomography (LDCT) and pulmonary function tests (PFT) to phenotypically subgroup a high-risk population. METHODS: Study group consisted of current or former smokers who underwent lung cancer screening with LDCT as a subgroup of Pittsburgh Lung Screening Study. In addition to LDCT, PFT and a symptom query questionnaire were obtained from each patient. RESULTS: The study group consisted of 3183 subjects (age 50-79) subdivided into eight groups according to presence of symptoms, obstruction on PFT and presence of emphysema on LDCT. A total of 501 (15.7%) subjects were asymptomatic, with no airflow obstruction or evidence of emphysema. There were 866 (27.2%) subjects with both obstruction on PFT and emphysema on LDCT, but only 660 (20.7%) had symptoms. Five hundred thirty (16.6%) of the subjects had no emphysema on LDCT but had obstruction on PFT, although only 370 (11.6%) had symptoms. Four hundred seventy-four (14.9%) of subjects had emphysema on LDCT, but no airflow obstruction, with 312 (9.8%) symptomatic. Finally, 812 (25.5%) of subjects had no evidence of airflow obstruction on PFT or emphysema on LDCT, but had symptoms. CONCLUSION: Combining LDCT with PFT and a comprehensive questionnaire allows subgroup classification of COPD phenotypes in a high-risk population and may lead to earlier intervention and an improved framework for future studies.
Authors: Ann G Schwartz; Christine M Lusk; Angela S Wenzlaff; Donovan Watza; Stephanie Pandolfi; Laura Mantha; Michele L Cote; Ayman O Soubani; Garrett Walworth; Antoinette Wozniak; Christine Neslund-Dudas; Amy A Ardisana; Michael J Flynn; Thomas Song; David L Spizarny; Paul A Kvale; Robert A Chapman; Shirish M Gadgeel Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-07-06 Impact factor: 4.254
Authors: Melinda C Aldrich; Heather M Munro; Michael Mumma; Eric L Grogan; Pierre P Massion; Timothy S Blackwell; William J Blot Journal: PLoS One Date: 2015-03-26 Impact factor: 3.240
Authors: Maria Sanchez-Carpintero Abad; Pablo Sanchez-Salcedo; Juan P de-Torres; Ana B Alcaide; Luis M Seijo; Jesus Pueyo; Gorka Bastarrika; Javier J Zulueta; Arantza Campo Journal: PLoS One Date: 2020-04-13 Impact factor: 3.240