Current Progress of COPD Early Detection: Key Points and Novel Strategies

Figures & data

Table 1 Summarized the Performance (AUC) of Various Alternative Tools Group by Different Criteria for Case-Finding Initiation Using Hand-Held Devices, Questionnaire, or Combination of Tools

Criteria for Case-Finding Initiation Case-Finding Tools	Smoking History Only	Respiratory Symptom Only	Combination of Smoke Status Respiratory Symptom
Hand-held devices
COPD-6	0.759–0.87^Citation45,Citation48–50,Citation54	0.91^Citation53	0.80^Citation47
PIKO-6	0.85^Citation44	-	0.86–0.93^Citation46,Citation51
Spirobank Smart	-	-	0.87–0.903^Citation55,Citation63
Questionnaires
COPD-PS	0.65–0.79^Citation50,Citation52,Citation57	-	0.64^Citation63
CDQ	0.67–0.8^Citation44,Citation52,Citation57,Citation59	-	-
Simple PUMA	0.7–0.76^Citation56,Citation58	-	-
Weighted PUMA	0.79^Citation58	-	-
CAPTURE	-	-	0.795–0.928^Citation61,Citation62
CAT	-	0.58^Citation60	-
COPD-DQ	-	0.71^Citation60
IPAG	-	-	0.676^Citation64
RHSQ	0.72^Citation50	-	-
EGARPOC	0.68^Citation50	-	-
LFQ	0.81^Citation57	-	-
Combination tools
COPD-PS+PFT	-	-	0.761^Citation65
CAPTURE +PFT	-	-	0.906–0.953^Citation61,Citation62
COLA instrument	-	-	0.83^Citation66

Abbreviations: -, not report; COPD-PS, Population Screener; CDQ, COPD diagnostic questionnaire; AUC, Area Under the Curve; CAPTURE, COPD assessment in primary care to identify undiagnosed respiratory disease and exacerbation risk; CAT, The COPD Assessment Test; COPD-DQ, COPD-Diagnostic Questionnaire; IPAG, International Primary Care Airways Group; RHSQ, Respiratory Health Screening Questionnaire; EGARPOC, COPD screening questionnaire from Terrassa; LFQ, Lung Function Questionnaire; PEF, peak expiratory flow; COLA, COPD in LMICs Assessment.

Table 2 Details of COPD Case-Finding Questionnaire

Questionnaire	CDQ	COPD-PS	LFQ	PUMA	CAPTURE	COLA	UCAP-Q
Item	Age	Age	Age	Age			Age
	Smoking history	Smoking history	Smoking history	Smoking history	Risk exposures Smoke Air pollution Weather	Personal exposures Smoke Biomass fuel daily	Smoking history Occupations Paint Chemicals Fumes Sandblasting
	Symptoms sputum wheeze	Symptoms shortness of breath frequency, cough	Symptoms Wheeze Dyspnea Cough	Symptoms Dyspnea Sputum Cough	Symptoms Breathing problems	Symptoms Sputum Wheeze Hospitalization due to respiratory symptoms in the past year	Symptom Cough Sleep Chest tightness Wheeze Chest problem
	BMI	Changes in exercise capacity		Gender	Tiring easily	Functional status daily activity	Functional status Vigorous Feel tired Emotional problem
	Allergic history			Previous use of spirometry	Recent history of acute respiratory illnesses

Abbreviations: BMI, Body Mass Index; COPD-PS, Population Screener; CDQ, COPD diagnostic questionnaire; CAPTURE, COPD assessment in primary care to identify undiagnosed respiratory disease and exacerbation risk; COLA, COPD in LMICs Assessment; LFQ, Lung Function Questionnaire; UCAP-Q, Undiagnosed COPD and Asthma Population Questionnaire.

Table 3 Details of COPD Case-Finding Prediction Models

Study	Mapel et al	Kotz et al	Haroon et al	Smidth et al	TargetCOPD	PCOPD
Variables		Age			Age	Age
		Smoking	Smoking		Smoking	Smoking pack-years
	Antibiotics Respiratory and cardiovascular medications		Salbutamol	Respiratory medication	Salbutamol Antibiotics
		Asthma	Asthma	Chronic lung disease	Dyspnoea	CAT score
		Socioeconomic status	Lower Respiratory Tract Infections	Previous spirometry data		Percent predicted PEF

Abbreviations: CAT, The COPD Assessment Test; PEF, peak expiratory flow.

Table 4 Summarized the Performance of COPD Case-Finding Prediction Models

Study	Mapel et al	Kotz et al	Haroon et al	Smidth et al	TargetCOPD	PCOPD
AUC	N/A	M: 0.85; F: 0.83	0.84	N/A	0.74	0.866
Cut-off value	N/A	M: 5.21–7.36; F: 5.24–7.34	2.5	N/A	7.5	0.65
SN	60.6	M: 42.5–0.3 F: 49.2–0.6	63.2	29.7	68.8	63
SP	70.5	M: 90.1–100 F: 89.3–99.9	87.4	98.9	68.8	90
PPV	14.3	N/A	22.6	72.9	14.4	86
NPV	95.6	N/A	97.6	93.4	96.6	72

Abbreviations: AUC, Area Under the Curve; SN, Sensitivity; SP, Specificity; PPV, positive predictive value; NPV, negative predictive value.

Figure 1 Proposed COPD case-finding flowchart.

Abbreviations: COPD-PS, Population Screener; CDQ, COPD diagnostic questionnaire; CAPTURE, COPD assessment in primary care to identify undiagnosed respiratory disease and exacerbation risk; COLA: COPD in LMICs Assessment.

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