VitalQPlus: a potential screening tool for early diagnosis of COPD

Figures & data

Figure 1 Flowchart of the study results.

Note: *Failure to provide a Vitalograph measurement – “!” symbol persisted after five repeated Vitalograph attempts.
Abbreviations: FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; FVC, forced vital capacity; COPD-PS, chronic obstructive pulmonary disease Population Screener.

Table 1 Characteristics of patients in three governmental primary care health centers

Demographic	Sabah region (n=63)	Perak region (n=11)	Penang region (n=9)	Total (n=83)
Age, years
Mean, SD	54.9±1.03*	51.4±1.3*	44.4±1.2	53.3±1.1
Median (range)	56 (37–78)	53 (35–70)	39 (35–68)*	54 (35–78)*
Sex, n (%)
Male	61 (96.8%)	11 (100%)	9 (100%)	81 (97.6%)
Female	2 (3.2%)	0 (0%)	0 (0%)	2 (2.4%)
Smoking history, n (%)
Active smoker	45 (71.4%)	9 (81.8%)	5 (55.6%)	59 (71.1%)#
Ex-smoker	18 (28.6%)	2 (18.2%)	4 (44.4%)	24 (28.9%)
Interested to quit, n (%)
Interested	24/45 (53.3%)	3/9 (33.3%)	4/5 (80%)	32/59 (54.2%)
Not interested	21/45 (46.7%)	6/9 (66.7%)	1/5 (20%)	27/59 (45.8%)
COPD-PS questionnaire
Score, n (%)
Score ≥5	21 (33.3%)	3 (27.3%)	2 (28.6%)	29 (65.1%)
Score <5	42 (66.7%)	8 (72.7%)	7 (71.4%)	54 (34.9%)
Vitalograph COPD-6
FEV1, L
Mean, SD	2.22±0.54	2.83±0.28*	2.47±0.64	2.33±0.56
Median (range)	2.28 (0.7–3.29)*	2.88 (2.27–3.26)	2.69 (0.9–3.03)*	2.35 (0.7–3.29*
FEV6, L
Mean, SD	2.61±0.59*	3.32±0.42*	2.96±0.84	2.74±0.6*
Median (range)	2.66 (1.07–3.85)	3.48 (2.59–3.94)	3.19 (0.93–3.66)*	2.79 (0.93–3.94)
FEV1/FEV6 ratio
Mean, SD	0.85±0.1	0.86±0.05	0.85±0.06*	0.85±0.09**
Median (range)	0.88 (0.62–1.0)*	0.85 (0.80–0.99)*	0.83 (0.79–0.97)	0.85 (0.62–1.0)
FEV1/FEV6 ratio ≥0.75, n (%)	50 (79.4%)	11 (100%)	9 (100%)	70 (84.3%)

Notes:

* Normal distribution;

** P<0.05.

# Three of the active smokers were using their homemade, rolled, and dried tobacco leaves.

Abbreviations: FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; COPD-PS, chronic obstructive pulmonary disease Population Screener; SD, standard deviation.

Table 2 Results comparison of COPD score, FEV1/FEV6, locations, and smoking status

Characteristic
Comparison between COPD score (≥5) versus normal score
	Score ≥5, n=29 (34.9%)	Score <5, n=54 (65.1%)
*Median age, years	61 (35–76)	49.5 (35–78)
Smoking history, n (%)
Active smoker	22 (75.9%)	38 (70.4%)
Ex-smoker	7 (24.1%)	16 (29.6%)
*Median FEV1, L	2.21 (range, 0.7–2.88)	2.47 (range, 1.14–3.29)
*Mean FEV6, L, SD	2.47±0.63	2.89±0.61
Mean FEV1/FEV6 ratio, SD	0.83±0.11	0.86±0.08
*FEV1/FEV6 ratio, n (%)
≥0.75	22 (75.9%)	48 (88.9%)
<0.75	7 (24.1%)	6 (11.1%)
Comparison between FEV1/FEV6 ratio of ≥ 0.75 versus, <0.75
	FEV1/FEV6, <0.75, n=13 (15.7%)	FEV1/FEV6 ≥0.75, n=70 (84.3%)
*Median age, years	61 (42–76)	53 (35–78)
Smoking history
Active smoker, n (%)	10 (76.9%)	49 (70%)
Ex-smoker, n (%)	3 (23.1%)	21 (30%)
*FEV1, median (L)	1.80 (0.7–2.47)	2.40 (0.9–3.29)
FEV6, mean (L), SD	2.44±0.78	2.8±0.61
*FEV1/FEV6, mean, SD	0.72±0.09	0.88±0.07
Score COPD-PS
≥5	7 (53.8%)	22 (31.4%)
<5	6 (46.2%)	48 (68.6%)
Comparison of Sabah versus Perak plus Penang subjects
	Sabah, n=63 (75.9%)	Perak plus Penang, n=20 (24.1%)
*Age (years), median	56 (37–78)	45.5 (35–70)
*FEV1, median	2.28 L (0.7–3.29)	2.83 L (0.9–3.26)
*FEV6, median	2.66 L (1.07–3.85)	3.35 L (0.93–3.94)
Mean FEV1/FEV6 ratio, SD	0.85±0.1	0.86±0.06
Smoking history, n (%)
Active smoker	45 (71.4%)	14 (70%)
Ex-smoker	18 (28.6%)	6 (30%)
Score COPD-PS, n (%)
≥5	24 (38.1%)	5 (25%)
<5	39 (61.9%)	15 (75%)
*FEV1/FEV6 ratio, n (%)
≥0.75	50 (79.4%)	20 (100%)
<0.75	13 (20.6%)	0 (0%)
Comparison between actives smokers and ex-smokers
	Active smoker, n=59 (71.1%)	Ex-smoker, n=24 (28.9%)
Mean age, years, SD	51.8±1.1	56.8±1.1
Mean FEV1, SD	2.28±0.59	2.45±0.45
Median FEV6	2.76 L (range, 0.93–3.94)	2.89 L (range, 1.60–3.73)
Median FEV1/FEV6 ratio	0.85 (range, 0.62–1.0)	0.86 (range, 0.67–1.0)
Score COPD-PS, n (%)
≥5	37 (62.7%)	17 (70.8%)
<5	22 (37.3%)	7 (29.2%)
FEV1/FEV6 ratio, n (%)
≥0.75	49 (83.1%)	21 (87.5%)
<0.75	10 (16.9%)	3 (12.5%)

Note:

* P<0.05.

Abbreviations: FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; COPD-PS, chronic obstructive pulmonary disease Population Screener; SD, standard deviation.

Table 3 Comparison between healthy/non-COPD and potentially undiagnosed COPD subjects

Demographic	Healthy/non-COPD	Potentially undiagnosed COPD
n (%)	48 (61.4%)	7 (8.4%)
*Average age, years, SD	50.2±1.04	68.4±5.4
*Mean FEV1, L, SD	2.53±0.47	1.57±0.69
*Mean FEV6, L, SD	2.92±0.61	2.28±0.89
*FEV1/FEV6 ratio, SD	0.87±0.06	0.68±0.05
Smoking history, n (%)
Active smoker	33 (68.8%)	6 (85.7%)
Ex-smoker	15 (31.2%)	1 (14.3%)
Location, n (%)
East Malaysia	33 (68.8%)	7 (100%)
West Malaysia	15 (31.2%)	0

Note:

* P<0.05.

Abbreviations: FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; SD, standard deviation.

Table 4 Comparison between COPD GOLD and our current study results based on FEV1 (%)

COPD stage FEV1/FVC <0.70	FEV1, %	*Results FEV1/FEV6 <0.75, n (%)
I	FEV1 ≥80%	3 (23.1%)
II	50%<FEV1 <80%	8 (61.5%)
III	30%<FEV1 <50%	2 (15.4%)
IV	FEV1<30%	0 (0%)

Note:

* The results are interpreted in FEV1/FEV6 <0.75 instead of FEV1/FVC <0.70, as in GOLD guidelines.

Abbreviations: GOLD, Global initiative for chronic Obstructive Lung Disease; FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; FVC, forced vital capacity.