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Clinical Investigations

Symptom-Based Questionnaire for Differentiating COPD and Asthma

Tinkelman D.G.a · Price D.B.b · Nordyke R.J.c, d · Halbert R.J.c, d · Isonaka S.c · Nonikov D.e · Juniper E.F.f · Freeman D.b · Hausen T.g · Levy M.L.k · Østrem A.h · van der Molen T.i · van Schayck C.P.j

Author affiliations

aNational Jewish Medical and Research Center, Denver, Colo., USA; bUniversity of Aberdeen, Aberdeen, UK; cCerner Health Insights, Beverly Hills, Calif., and dUCLA School of Public Health, Los Angeles, Calif., USA; eWiesbaden, Germany; fMcMaster University, Hamilton, Canada; gEssen, Germany; hOslo, Norway; iUniversity of Groningen, Groningen, and jUniversity of Maastricht, Maastricht, Netherlands; kUniversity of Edinburgh, Edinburgh, UK

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Respiration 2006;73:296–305

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Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: May 05, 2006
Issue release date: May 2006

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 6

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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.

© 2006 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: May 05, 2006
Issue release date: May 2006

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 6

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES


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