Symptom-based questionnaire for identifying COPD in smokers

David B. Price, David G. Tinkelman, R. J. Halbert, Robert J. Nordyke, 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

142 Citations (Scopus)

Abstract

Background: Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care. Objectives: We prospectively tested questions to help identify COPD among smokers without prior history of lung disease. Methods: Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo., USA. Current and former smokers aged 40 or older with no prior respiratory diagnosis and no respiratory medications in the past year were enrolled. Participants answered questions covering demographics and symptoms and then underwent spirometry with reversibility testing. A study diagnosis of COPD was defined as fixed airway obstruction as measured by postbronchodilator FEV1/FVC <0.70. We examined the ability of individual questions in a multivariate framework to correctly discriminate between persons with and without COPD. Results: 818 subjects completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analysis, which was reduced to 17 items for entry into multivariate regression. Eight items had significant relationships with the study diagnosis of COPD, including age, pack-years, body mass index, weather-affected cough, phlegm without a cold, morning phlegm, wheeze frequency, and history of any allergies. Individual items yielded odds ratios ranging from 0.23 to 12. This questionnaire demonstrated a sensitivity of 80.4 and specificity of 72.0. Conclusions: A simple patient self-administered questionnaire can be used to identify patients with a high likelihood of having COPD, for whom spirometric testing is particularly important. Implementation of this questionnaire could enhance the efficiency and diagnostic accuracy of current screening efforts. Copyright (C) 2006 S. Karger AG, Basel.

Original languageEnglish
Pages (from-to)285-295
Number of pages11
JournalRespiration
Volume73
Issue number3
DOIs
Publication statusPublished - 2006

Keywords

  • Adult
  • Colorado
  • Diagnosis, Differential
  • Female
  • Forced Expiratory Volume
  • Great Britain
  • Humans
  • Incidence
  • Male
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive
  • Questionnaires
  • Reproducibility of Results
  • Smoking
  • Spirometry
  • Diagnosis
  • Primary care
  • Air-flow obstruction
  • validation studies
  • Obstructive pulmonary-disease
  • General practice
  • Risk
  • Population
  • Guidelines
  • Diagnosis
  • Program
  • Asthma

Cite this

Price, D. B., Tinkelman, D. G., Halbert, R. J., Nordyke, R. J., Isonaka, S., Nonikov, D., ... van Schayck, C. P. (2006). Symptom-based questionnaire for identifying COPD in smokers. Respiration, 73(3), 285-295. https://doi.org/10.1159/000090142

Symptom-based questionnaire for identifying COPD in smokers. / Price, David B.; Tinkelman, David G.; Halbert, R. J.; Nordyke, Robert 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. 285-295.

Research output: Contribution to journalArticle

Price, DB, Tinkelman, DG, Halbert, RJ, Nordyke, 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 identifying COPD in smokers', Respiration, vol. 73, no. 3, pp. 285-295. https://doi.org/10.1159/000090142
Price DB, Tinkelman DG, Halbert RJ, Nordyke RJ, Isonaka S, Nonikov D et al. Symptom-based questionnaire for identifying COPD in smokers. Respiration. 2006;73(3):285-295. https://doi.org/10.1159/000090142
Price, David B. ; Tinkelman, David G. ; Halbert, R. J. ; Nordyke, Robert 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 identifying COPD in smokers. In: Respiration. 2006 ; Vol. 73, No. 3. pp. 285-295.
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abstract = "Background: Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care. Objectives: We prospectively tested questions to help identify COPD among smokers without prior history of lung disease. Methods: Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo., USA. Current and former smokers aged 40 or older with no prior respiratory diagnosis and no respiratory medications in the past year were enrolled. Participants answered questions covering demographics and symptoms and then underwent spirometry with reversibility testing. A study diagnosis of COPD was defined as fixed airway obstruction as measured by postbronchodilator FEV1/FVC <0.70. We examined the ability of individual questions in a multivariate framework to correctly discriminate between persons with and without COPD. Results: 818 subjects completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analysis, which was reduced to 17 items for entry into multivariate regression. Eight items had significant relationships with the study diagnosis of COPD, including age, pack-years, body mass index, weather-affected cough, phlegm without a cold, morning phlegm, wheeze frequency, and history of any allergies. Individual items yielded odds ratios ranging from 0.23 to 12. This questionnaire demonstrated a sensitivity of 80.4 and specificity of 72.0. Conclusions: A simple patient self-administered questionnaire can be used to identify patients with a high likelihood of having COPD, for whom spirometric testing is particularly important. Implementation of this questionnaire could enhance the efficiency and diagnostic accuracy of current screening efforts. Copyright (C) 2006 S. Karger AG, Basel.",
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AU - Price, David B.

AU - Tinkelman, David G.

AU - Halbert, R. J.

AU - Nordyke, Robert 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.

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N2 - Background: Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care. Objectives: We prospectively tested questions to help identify COPD among smokers without prior history of lung disease. Methods: Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo., USA. Current and former smokers aged 40 or older with no prior respiratory diagnosis and no respiratory medications in the past year were enrolled. Participants answered questions covering demographics and symptoms and then underwent spirometry with reversibility testing. A study diagnosis of COPD was defined as fixed airway obstruction as measured by postbronchodilator FEV1/FVC <0.70. We examined the ability of individual questions in a multivariate framework to correctly discriminate between persons with and without COPD. Results: 818 subjects completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analysis, which was reduced to 17 items for entry into multivariate regression. Eight items had significant relationships with the study diagnosis of COPD, including age, pack-years, body mass index, weather-affected cough, phlegm without a cold, morning phlegm, wheeze frequency, and history of any allergies. Individual items yielded odds ratios ranging from 0.23 to 12. This questionnaire demonstrated a sensitivity of 80.4 and specificity of 72.0. Conclusions: A simple patient self-administered questionnaire can be used to identify patients with a high likelihood of having COPD, for whom spirometric testing is particularly important. Implementation of this questionnaire could enhance the efficiency and diagnostic accuracy of current screening efforts. Copyright (C) 2006 S. Karger AG, Basel.

AB - Background: Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care. Objectives: We prospectively tested questions to help identify COPD among smokers without prior history of lung disease. Methods: Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo., USA. Current and former smokers aged 40 or older with no prior respiratory diagnosis and no respiratory medications in the past year were enrolled. Participants answered questions covering demographics and symptoms and then underwent spirometry with reversibility testing. A study diagnosis of COPD was defined as fixed airway obstruction as measured by postbronchodilator FEV1/FVC <0.70. We examined the ability of individual questions in a multivariate framework to correctly discriminate between persons with and without COPD. Results: 818 subjects completed all investigations and proceeded to analysis. The list of 54 questions yielded 52 items for analysis, which was reduced to 17 items for entry into multivariate regression. Eight items had significant relationships with the study diagnosis of COPD, including age, pack-years, body mass index, weather-affected cough, phlegm without a cold, morning phlegm, wheeze frequency, and history of any allergies. Individual items yielded odds ratios ranging from 0.23 to 12. This questionnaire demonstrated a sensitivity of 80.4 and specificity of 72.0. Conclusions: A simple patient self-administered questionnaire can be used to identify patients with a high likelihood of having COPD, for whom spirometric testing is particularly important. Implementation of this questionnaire could enhance the efficiency and diagnostic accuracy of current screening efforts. Copyright (C) 2006 S. Karger AG, Basel.

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