Performance and Clinical Utility of Various Chronic Obstructive Pulmonary Disease Case-Finding Tools

Figures & data

Figure 1 Study Procedure.

Table 1 Participant Demographics and Characteristics

Variables	Non-COPD	COPD	Total	P-value
Sample size	284	101	385	–
Gender
Male	270 (95.1%)	94 (93.1%)	364 (94.5%)	0.447
Female	14 (4.9%)	7 (6.9%)	21 (5.5%)
Age	59.1±0.6	65.8±1.0	60.9±0.5	<0.0001
<55	88 (31.0%)	13 (12.9%)	101 (26.2%)	<0.0001
55–60	55 (19.4%)	12 (11.9%)	67 (17.4%)
61–65	60 (21.1%)	17 (16.8%)	77 (20.0%)
>65	81 (28.5%)	59 (58.4%)	140 (36.4%)
BMI	25.81±0.23	24.22±0.40	25.39±0.20	<0.0001
Smoke pack year	39.90±1.60	48.70±2.90	42.2±1.50	0.008
< 50	221 (77.8%)	59 (58.4%)	280 (72.2%)	<0.0001
≥ 50	63 (22.2%)	42 (41.6%)	105 (27.3%)
CAT	9±0	12±1	10±0	<0.0001
0–10	191 (67.3%)	47 (46.5%)	238 (61.8%)	0.002
11–20	79 (27.8%)	42 (41.6%)	121 (31.4%)
21–30	13 (4.6%)	11 (10.9%)	24 (6.2%)
31–40	1 (0.4%)	1 (1.0%)	2 (0.5%)
COPD-PS	4.8±0.1	6.2±0.2	5.2±0.1	<0.0001
1–5	190 (67.4%)	36 (35.6%)	226 (59.0%)	<0.0001
6–10	92 (32.6%)	65 (64.4%)	157 (41.0%)
PCOPD	0.49±0.03	0.75±0.02	0.56±0.02	<0.0001
Mobile FEV1/FVC	81.34±0.44	63.16±1.31	76.57±0.62	<0.0001
Post-BD FEV1/FVC	81.00±0.42	58.88±0.90	75.20±0.63	<0.0001
Severity
GOLD 1		24 (23.8%)		<0.0001
GOLD 2		53 (52.5%)
GOLD 3		21 (20.8%)
GOLD 4		3 (3.0%)

Figure 2 Receiver-operating characteristic (ROC) curves for Spirobank Smart, and P_COPD, COPD-PS. (A) Spirobank Smart (FEV1/FVC); (B) P_COPD; (C) COPD-PS.

Figure 3 Decision curve analysis and clinical impact curves for Spirobank Smart, and P_COPD prediction model, COPD-PS. (A) Decision curve for Spirobank Smart, P_COPD, and COPD-PS; (B) Clinical impact curves for Spirobank Smart; (C) Clinical impact curves for P_COPD; (D) Clinical impact curves for COPD-PS.

Table 2 Sensitivity, Specificity, PPV, NPV, and Area Under the Receiver Operating Curve for Spirometry, the P_COPD Model, and the COPD-PS Questionnaire

Cut Point for Difference Tools	Sensitivity	Specificity	PPV	NPV	AUROC (95% CI)
Mobile spirometer: FEV1/FVC ≤ 74%	84.20%	90.14%	75.22%	94.12%	0.871 (0.78–0.89)
PCOPD ≥ 0.74	66.30%	79.23%	53.17%	86.87%	0.728 (0.67–0.79)
COPD PS score ≥ 5	83.20%	45.07%	35.00%	88.28%	0.641 (0.58–0.70)

Table 3 Univariate and Multivariate Logistic Regression for the Associations of FEV1/FVC Ratio with COPD Prevalence

Variables	Crude OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value
Gender, Male	0.70 (0.27–1.78)	0.449	0.461 (0.116–1.827)	0.271	0.55 (0.19–1.61)	0.275	0.50 (0.18–1.43)	0.196
Age category
<55	1		1		1		1
55–60	1.48 (0.63–3.47)	0.371	2.32 (0.715–7.525)	0.161	1.33 (0.51–3.43)	0.561	1.57 (0.63–3.93)	0.334
61–65	1.92 (0.87–4.24)	0.108	3.62 (1.16–11.27)	0.026	1.47 (0.60–3.60)	0.401	1.39 (0.58–3.36)	0.463
>65	4.93 (2.52–9.66)	<0.0001	5.46 (2.05–14.53)	0.001	2.85 (1.30–6.23)	0.009	3.23 (1.51–6.89)	0.002
Smoke pack year
< 50	1		1		1		1
≥ 50	2.50 (1.54–4.05)	<0.0001	1.22 (0.56–2.63)	0.620	1.66 (0.92–2.98)	0.09	2.35 (1.35–4.09)	0.003
BMI	0.89 (0.84–0.95)	0.001	0.94 (0.85–1.03)	0.169	0.89 (0.82–0.95)	0.001	0.89 (0.83–0.95)	0.001
CAT category
0–10	1		1		1		1
11–20	2.16 (1.32–3.53)	0.002	1.70 (0.80–3.62)	0.164	1.93 (1.09–3.42)	0.024	1.98 (1.13–3.45)	0.016
21–30	3.44 (1.45–8.16)	0.005	3.12 (0.89–10.90)	0.740	2.16 (0.77–6.07)	450.1	2.76 (1.02–7.47)	0.045
31–40	4.06 (0.25–66.17)	0.325	7.06 (0.07–74)	0.410	3.29 (0.10–111.90)	0.508	4.72 (0.16–143.30)	0.373
Mobile spirometer: FEV1/FVC ≤ 74%	48.57 (25.07–94.11)	<0.0001	43.88 (21.34–90.21)	<0.0001
PCOPD ≥ 0.74	7.51 (4.55–12.42)	<0.0001			4.91 (2.82–8.55)	<0.0001
COPD-PS score ≥ 5	4.05 (2.29–7.18)	<0.0001					2.76 (1.45–5.27)	0.002