Novel Approach Helps Primary Care Providers Diagnose COPD

A new 5-question assessment plus peak flow (PEF) test can help primary care providers diagnose chronic obstructive pulmonary disease (COPD), according to a new report.

COPD is a common lung condition in the United States, and it is believed that millions of Americans with the disease could go undiagnosed.
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In an effort to develop a method for identifying undiagnosed COPD in the primary care setting, the researchers crafted a questionnaire—COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURETM©)—which was cut from its original 44 questions down to 5 questions about smoke and pollution exposure, breathing problems, how easily the patients tire, and number of acute respiratory illnesses.

Based on the questionnaire, patients who were at high risk of COPD were immediately referred for definitive diagnostic testing, those who were in the middle range for risk completed a PEF test, and those at low risk did not need further testing.

Men and women in the mid-range who exhaled less than 350 l/m and 250 l/m, respectively, were referred for definitive testing.

In a case-control study of 346 men and women, 52% required PEF to determine whether further diagnostic testing was required.

The questionnaire plus PEF testing had an 89.7% sensitivity rate and a 78.1% specificity rate for cases vs controls.

“CAPTURETM© with PEF can identify COPD patients who would benefit from currently available therapy and require further diagnostic evaluation,” the researchers conclude.

—Amanda Balbi

Reference:

Martinez FJ, Mannino D, Leidy NK, et al. A new approach for identifying patients with undiagnosed chronic obstructive pulmonary disease [published online October 26, 2016]. Am J Respir Crit Care Med. doi:10.1164/rccm.201603-0622OC.