Symptom-based questionnaire for differentiating COPD and asthma

David G Tinkelman, David Brendan 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

Research output: Contribution to journalArticle

68 Citations (Scopus)

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 FEV1/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.

Original languageEnglish
Pages (from-to)296-305
Number of pages10
JournalRespiration
Volume73
Issue number3
DOIs
Publication statusPublished - 2006

Keywords

  • Adult
  • Aged
  • Asthma
  • Colorado
  • Diagnosis, Differential
  • Female
  • Forced Expiratory Volume
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive
  • Questionnaires
  • Scotland
  • Spirometry

Cite this

Tinkelman, D. G., Price, D. B., Nordyke, R. J., Halbert, R. J., Isonaka, S., Nonikov, D., ... van Schayck, C. P. (2006). Symptom-based questionnaire for differentiating COPD and asthma. Respiration, 73(3), 296-305. https://doi.org/10.1159/000090141

Symptom-based questionnaire for differentiating COPD and asthma. / Tinkelman, David G; Price, David Brendan; Nordyke, Robert J; Halbert, R J; Isonaka, Sharon; Nonikov, Dmitry; Juniper, Elizabeth F; Freeman, Daryl; Hausen, Thomas; Levy, Mark L; Ostrem, Anders; van der Molen, Thys; van Schayck, Constant P.

In: Respiration, Vol. 73, No. 3, 2006, p. 296-305.

Research output: Contribution to journalArticle

Tinkelman, DG, Price, DB, Nordyke, RJ, Halbert, RJ, Isonaka, S, Nonikov, D, Juniper, EF, Freeman, D, Hausen, T, Levy, ML, Ostrem, A, van der Molen, T & van Schayck, CP 2006, 'Symptom-based questionnaire for differentiating COPD and asthma', Respiration, vol. 73, no. 3, pp. 296-305. https://doi.org/10.1159/000090141
Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ, Isonaka S, Nonikov D et al. Symptom-based questionnaire for differentiating COPD and asthma. Respiration. 2006;73(3):296-305. https://doi.org/10.1159/000090141
Tinkelman, David G ; Price, David Brendan ; Nordyke, Robert J ; Halbert, R J ; Isonaka, Sharon ; Nonikov, Dmitry ; Juniper, Elizabeth F ; Freeman, Daryl ; Hausen, Thomas ; Levy, Mark L ; Ostrem, Anders ; van der Molen, Thys ; van Schayck, Constant P. / Symptom-based questionnaire for differentiating COPD and asthma. In: Respiration. 2006 ; Vol. 73, No. 3. pp. 296-305.
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AU - Tinkelman, David G

AU - Price, David Brendan

AU - Nordyke, Robert J

AU - Halbert, R J

AU - Isonaka, Sharon

AU - Nonikov, Dmitry

AU - Juniper, Elizabeth F

AU - Freeman, Daryl

AU - Hausen, Thomas

AU - Levy, Mark L

AU - Ostrem, Anders

AU - van der Molen, Thys

AU - van Schayck, Constant P

N1 - Copyright (c) 2006 S. Karger AG, Basel.

PY - 2006

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N2 - 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 FEV1/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.

AB - 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 FEV1/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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KW - Diagnosis, Differential

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KW - Forced Expiratory Volume

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KW - Incidence

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KW - Middle Aged

KW - Odds Ratio

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive

KW - Questionnaires

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KW - Spirometry

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JO - Respiration

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