Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care?

Abstract

Background and aim

Early detection of COPD may reduce the future burden of the disease. We aimed to investigate whether prescreening with a COPD-6 screening device (measuring FEV₁ and FEV₆) facilitates early detection of COPD in primary care.

Methods

In primary care, individuals at high risk of COPD (ie, age ≥35 years, relevant exposure, and at least one respiratory symptom) and no previous diagnosis of obstructive lung disease were examined with a COPD-6 screening device. In prioritized order, the criteria for proceeding to confirmatory spirometry were FEV₁/FEV₆ <0.7, FEV₁ <80%pred, or clinical suspicion of COPD regardless of test result (medical doctor’s [MD] decision). Based on spirometry, including bronchodilator (BD) reversibility test, individuals were classified as COPD (post-BD FEV₁/FVC <0.70), asthma (ΔFEV₁ ≥0.50 L), or no obstructive lung disease.

Results

A total of 2,990 subjects (54% men, mean age 59 years, and mean 28 pack-years) were enrolled, of whom 949 (32%) proceeded from COPD-6 screening to confirmative spirometry based on the following criteria: 510 (54%) FEV₁/FEV₆ <0.70, 382 (40%) FEV₁ <80%pred, and 57 (6%) MD decision. Following confirmative spirometry, the 949 individuals were diagnosed as having COPD (51%), asthma (3%), and no obstructive lung disease (45%). COPD was diagnosed in 487 (16%) of the enrolled subjects in whom confirmative spirometry was performed in 69% based on FEV₁/FEV₆ <0.7 and in 29% based on FEV₁ ≤80%pred.

Conclusion

Prescreening with the COPD-6 device showed acceptable specificity for the selection of subjects for diagnostic spirometry and is likely to be a useful alternative to current practice in primary care.

Keywords:

• early COPD
• diagnosis
• spirometry
• general practice

Acknowledgments

The authors wish to thank all participating GPs, their staff, and, not least of all, participating individuals.

The study was financially funded by Boehringer-Ingelheim, Denmark. The financial support provided by Boehringer-Ingelheim had no influence on the content of the manuscript. None of the authors received any compensation related to the development of this manuscript.

Author contributions

All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

All the authors are members of the TOPTrack steering committee. The authors report no other conflicts of interest in this work.