Case-finding options for COPD

Results from the burden of obstructive lung disease study

Anamika Jithoo, Paul L. Enright, Peter Burney, A (Sonia) Buist, Eric D. Bateman, Wan C. Tan, Michael Studnicka, Filip Mejza, Suzanne Gillespie, William M. Vollmer

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

This study aimed to compare strategies for chronic obstructive pulmonary disease (COPD) case finding using data from the Burden of Obstructive Lung Disease study. Population-based samples of adults aged o40 yrs (n59,390) from 14 countries completed a questionnaire and spirometry. We compared the screening efficiency of differently staged algorithms that used questionnaire data and/or peak expiratory flow (PEF) data to identify persons at risk for COPD and, hence, needing confirmatory spirometry. Separate algorithms were fitted for moderate/severe COPD and for severe COPD. We estimated the cost of each algorithm in 1,000 people. For moderate/severe COPD, use of questionnaire data alone permitted high sensitivity (97%) but required confirmatory spirometry in 80% of participants. Use of PEF necessitated confirmatory spirometry in only 19-22% of subjects, with 83-84% sensitivity. For severe COPD, use of PEF achieved 91-93% sensitivity, requiring confirmatory spirometry in ,9% of participants. Cost analysis suggested that a staged screening algorithm using only PEF initially, followed by confirmatory spirometry as needed, was the most cost-effective case-finding strategy. Our results support the use of PEF as a simple, cost-effective initial screening tool for conducting COPD case-finding in adults agedo40 yrs. These findings should be validated in realworld settings such as the primary care environment.

Original languageEnglish (US)
Pages (from-to)548-555
Number of pages8
JournalEuropean Respiratory Journal
Volume41
Issue number3
DOIs
StatePublished - Mar 1 2013

Fingerprint

Obstructive Lung Diseases
Spirometry
Chronic Obstructive Pulmonary Disease
Costs and Cost Analysis
Primary Health Care

Keywords

  • Adult
  • Chronic obstructive pulmonary disease
  • Epidemiology
  • Peak expiratory flow
  • Questionnaire
  • Screening

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Jithoo, A., Enright, P. L., Burney, P., Buist, A. S., Bateman, E. D., Tan, W. C., ... Vollmer, W. M. (2013). Case-finding options for COPD: Results from the burden of obstructive lung disease study. European Respiratory Journal, 41(3), 548-555. https://doi.org/10.1183/09031936.00132011

Case-finding options for COPD : Results from the burden of obstructive lung disease study. / Jithoo, Anamika; Enright, Paul L.; Burney, Peter; Buist, A (Sonia); Bateman, Eric D.; Tan, Wan C.; Studnicka, Michael; Mejza, Filip; Gillespie, Suzanne; Vollmer, William M.

In: European Respiratory Journal, Vol. 41, No. 3, 01.03.2013, p. 548-555.

Research output: Contribution to journalArticle

Jithoo, A, Enright, PL, Burney, P, Buist, AS, Bateman, ED, Tan, WC, Studnicka, M, Mejza, F, Gillespie, S & Vollmer, WM 2013, 'Case-finding options for COPD: Results from the burden of obstructive lung disease study', European Respiratory Journal, vol. 41, no. 3, pp. 548-555. https://doi.org/10.1183/09031936.00132011
Jithoo, Anamika ; Enright, Paul L. ; Burney, Peter ; Buist, A (Sonia) ; Bateman, Eric D. ; Tan, Wan C. ; Studnicka, Michael ; Mejza, Filip ; Gillespie, Suzanne ; Vollmer, William M. / Case-finding options for COPD : Results from the burden of obstructive lung disease study. In: European Respiratory Journal. 2013 ; Vol. 41, No. 3. pp. 548-555.
@article{dddc4d27a09e4429b14c40baf43ca63c,
title = "Case-finding options for COPD: Results from the burden of obstructive lung disease study",
abstract = "This study aimed to compare strategies for chronic obstructive pulmonary disease (COPD) case finding using data from the Burden of Obstructive Lung Disease study. Population-based samples of adults aged o40 yrs (n59,390) from 14 countries completed a questionnaire and spirometry. We compared the screening efficiency of differently staged algorithms that used questionnaire data and/or peak expiratory flow (PEF) data to identify persons at risk for COPD and, hence, needing confirmatory spirometry. Separate algorithms were fitted for moderate/severe COPD and for severe COPD. We estimated the cost of each algorithm in 1,000 people. For moderate/severe COPD, use of questionnaire data alone permitted high sensitivity (97{\%}) but required confirmatory spirometry in 80{\%} of participants. Use of PEF necessitated confirmatory spirometry in only 19-22{\%} of subjects, with 83-84{\%} sensitivity. For severe COPD, use of PEF achieved 91-93{\%} sensitivity, requiring confirmatory spirometry in ,9{\%} of participants. Cost analysis suggested that a staged screening algorithm using only PEF initially, followed by confirmatory spirometry as needed, was the most cost-effective case-finding strategy. Our results support the use of PEF as a simple, cost-effective initial screening tool for conducting COPD case-finding in adults agedo40 yrs. These findings should be validated in realworld settings such as the primary care environment.",
keywords = "Adult, Chronic obstructive pulmonary disease, Epidemiology, Peak expiratory flow, Questionnaire, Screening",
author = "Anamika Jithoo and Enright, {Paul L.} and Peter Burney and Buist, {A (Sonia)} and Bateman, {Eric D.} and Tan, {Wan C.} and Michael Studnicka and Filip Mejza and Suzanne Gillespie and Vollmer, {William M.}",
year = "2013",
month = "3",
day = "1",
doi = "10.1183/09031936.00132011",
language = "English (US)",
volume = "41",
pages = "548--555",
journal = "European Respiratory Journal, Supplement",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "3",

}

TY - JOUR

T1 - Case-finding options for COPD

T2 - Results from the burden of obstructive lung disease study

AU - Jithoo, Anamika

AU - Enright, Paul L.

AU - Burney, Peter

AU - Buist, A (Sonia)

AU - Bateman, Eric D.

AU - Tan, Wan C.

AU - Studnicka, Michael

AU - Mejza, Filip

AU - Gillespie, Suzanne

AU - Vollmer, William M.

PY - 2013/3/1

Y1 - 2013/3/1

N2 - This study aimed to compare strategies for chronic obstructive pulmonary disease (COPD) case finding using data from the Burden of Obstructive Lung Disease study. Population-based samples of adults aged o40 yrs (n59,390) from 14 countries completed a questionnaire and spirometry. We compared the screening efficiency of differently staged algorithms that used questionnaire data and/or peak expiratory flow (PEF) data to identify persons at risk for COPD and, hence, needing confirmatory spirometry. Separate algorithms were fitted for moderate/severe COPD and for severe COPD. We estimated the cost of each algorithm in 1,000 people. For moderate/severe COPD, use of questionnaire data alone permitted high sensitivity (97%) but required confirmatory spirometry in 80% of participants. Use of PEF necessitated confirmatory spirometry in only 19-22% of subjects, with 83-84% sensitivity. For severe COPD, use of PEF achieved 91-93% sensitivity, requiring confirmatory spirometry in ,9% of participants. Cost analysis suggested that a staged screening algorithm using only PEF initially, followed by confirmatory spirometry as needed, was the most cost-effective case-finding strategy. Our results support the use of PEF as a simple, cost-effective initial screening tool for conducting COPD case-finding in adults agedo40 yrs. These findings should be validated in realworld settings such as the primary care environment.

AB - This study aimed to compare strategies for chronic obstructive pulmonary disease (COPD) case finding using data from the Burden of Obstructive Lung Disease study. Population-based samples of adults aged o40 yrs (n59,390) from 14 countries completed a questionnaire and spirometry. We compared the screening efficiency of differently staged algorithms that used questionnaire data and/or peak expiratory flow (PEF) data to identify persons at risk for COPD and, hence, needing confirmatory spirometry. Separate algorithms were fitted for moderate/severe COPD and for severe COPD. We estimated the cost of each algorithm in 1,000 people. For moderate/severe COPD, use of questionnaire data alone permitted high sensitivity (97%) but required confirmatory spirometry in 80% of participants. Use of PEF necessitated confirmatory spirometry in only 19-22% of subjects, with 83-84% sensitivity. For severe COPD, use of PEF achieved 91-93% sensitivity, requiring confirmatory spirometry in ,9% of participants. Cost analysis suggested that a staged screening algorithm using only PEF initially, followed by confirmatory spirometry as needed, was the most cost-effective case-finding strategy. Our results support the use of PEF as a simple, cost-effective initial screening tool for conducting COPD case-finding in adults agedo40 yrs. These findings should be validated in realworld settings such as the primary care environment.

KW - Adult

KW - Chronic obstructive pulmonary disease

KW - Epidemiology

KW - Peak expiratory flow

KW - Questionnaire

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=84875266353&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875266353&partnerID=8YFLogxK

U2 - 10.1183/09031936.00132011

DO - 10.1183/09031936.00132011

M3 - Article

VL - 41

SP - 548

EP - 555

JO - European Respiratory Journal, Supplement

JF - European Respiratory Journal, Supplement

SN - 0903-1936

IS - 3

ER -