Validation of a COPD screening questionnaire and establishment of diagnostic cut-points in a Japanese general population: the Hisayama study

Allergol Int. 2015 Jan;64(1):49-53. doi: 10.1016/j.alit.2014.06.002. Epub 2014 Dec 17.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is highly prevalent worldwide. COPD is a treatable disease and it is important to identify COPD subjects, highlighting the need for an efficient screening measure. Although the COPD screening questionnaire (COPD Population Screener, COPD-PS) was developed as a screening tool, its validity is not clear in population-based studies. This study determines the validity of the COPD-PS in the general Japanese population.

Methods: All registered residents living in the town of Hisayama aged above 40 were solicited to participate in a health check-up in 2012. All subjects aged 40-79 without physician-diagnosed asthma or lung resection were recruited, and 2357 subjects with the COPD-PS recorded and valid spirometry measurements were analyzed. Persistent airflow obstruction (AO) was defined by post-bronchodilator FEV1/FVC < 0.7. The sensitivity and specificity of the COPD-PS score for identifying AO was assessed by logistic regression analysis.

Results: The prevalence of AO in this population was 6.5%. The overall area under the receiver operating characteristic (ROC) curve for the continuous COPD-PS score was 0.748. A cut-point of 4-points is recommended, resulting in a sensitivity of 67.1% and specificity of 72.9% with an area under the ROC curve of 0.70. The positive predictive value was 14.6% and negative predictive value was 97.0%.

Conclusions: The COPD-PS appears to be an adequate measure for large scale screening of possible airflow obstruction requiring further testing with spirometry.

Keywords: Bronchodilators; Chronic obstructive pulmonary disease; Pulmonary function tests; Questionnaires; Screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asian People*
  • Female
  • Forced Expiratory Volume
  • Humans
  • Japan
  • Male
  • Mass Screening*
  • Middle Aged
  • Odds Ratio
  • Population Surveillance
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • ROC Curve
  • Reference Values
  • Reproducibility of Results
  • Respiratory Function Tests*
  • Risk Factors
  • Spirometry
  • Surveys and Questionnaires*