1
|
Plaza Zamora FJ, Figueira-Gonçalves JM, de Miguel-Díez J. [Collaboration of the Community Pharmacist in the Underdiagnosis of Chronic Obstructive Pulmonary Disease (COPD)]. OPEN RESPIRATORY ARCHIVES 2024; 6:100329. [PMID: 38764718 PMCID: PMC11101702 DOI: 10.1016/j.opresp.2024.100329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024] Open
Affiliation(s)
| | | | - Javier de Miguel-Díez
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, España
| |
Collapse
|
2
|
Yang X, Liao J, Zhu S, Zhang C, Ma X, Zhang C, Wang Y, Sun K, Wang G. Association of high-sensitivity CRP and FEV1%pred: a study on non-pulmonary disease in a population in Beijing, China. BMJ Open Respir Res 2024; 11:e001699. [PMID: 38479820 PMCID: PMC10941139 DOI: 10.1136/bmjresp-2023-001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 02/09/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND No studies have investigated whether high-sensitivity C reactive protein (hsCRP) can be used to predict the forced expiratory volume in 1 s (FEV1)/estimated value of FEV1 (FEV1%pred). This study aimed to assess the association between hsCRP and FEV1%pred in middle-aged and elderly individuals without underlying lung disease. METHODS The data for this study were obtained from a prospective cohort study that included 1047 middle-aged and elderly citizens from Beijing aged 40-75 years without any evidence of underlying lung diseases with FEV1 >70% after receiving inhalational bronchodilators. The baseline analysis of the participants was performed from 30 May 2018 to 31 October 2018. Restricted cubic spline regression and multivariate linear regression models were used to assess the non-linear association and linear association between hsCRP and FEV1/FEV in 6 s (FEV6) and FEV1%pred, respectively. RESULTS The hsCRP values of 851 participants were recorded; the values were normal in 713 (83.8%) participants. The remaining 196 participants (18.7%) had missing data. A non-linear association was observed between normal hsCRP values and FEV1/FEV6. hsCRP was linearly and negatively correlated with FEV1%pred, and each 1 SD increase in hsCRP was significantly associated with a 2.4% lower in FEV1%pred. Significantly higher FEV1/FEV6 differences were observed in the female subgroup than those in the male subgroup (p=0.011 for interaction). CONCLUSIONS hsCRP had a non-linear association with FEV1/FEV6 and a linear negative association with FEV1%pred in individuals with normal hsCRP values. hsCRP can be used to predict FEV1%pred, which can be used to predict the development of chronic obstructive pulmonary disease. hsCRP has a stronger association with lung function in women than that in men. TRIAL REGISTRATION NUMBER NCT03532893.
Collapse
Affiliation(s)
- Xiaoyu Yang
- Peking University First Hospital, Beijing, China
| | - Jiping Liao
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Sainan Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Cheng Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xiaoyu Ma
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Chunbo Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yunxia Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Kunyan Sun
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| |
Collapse
|
3
|
Accuracy of portable spirometers in the diagnosis of chronic obstructive pulmonary disease A meta-analysis. NPJ Prim Care Respir Med 2022; 32:15. [PMID: 35440665 PMCID: PMC9019105 DOI: 10.1038/s41533-022-00275-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/11/2022] [Indexed: 12/03/2022] Open
Abstract
Portable spirometers has been approved for diagnosing chronic obstructive pulmonary disease (COPD). However, their diagnostic accuracy has not been reviewed. Therefore, the purpose of this study was to systematically evaluate the diagnostic value of portable spirometers in detecting COPD. A comprehensive literature search for relevant studies was conducted in PubMed, Embase, CNKI, Wan Fang, and Web of Science databases. Pooled sensitivity, specificity, summary receiver operating characteristic (SROC), area under the curve (AUC), and other related indices were calculated using the bivariate mixed-effect model. Subgroup analysis was performed to explore the source of heterogeneity. Thirty one studies were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), SROC, and AUC of the SROC of portable spirometers were 0.85 (0.81–0.88), 0.85 (0.81–0.88), 5.6 (4.4–7.3), 0.18 (0.15–0.22), 31 (21–46) and 0.91 (0.89–0.94), respectively. Among the three commonly used types of portable spirometers, the accuracy of PIKO-6 was higher (0.95) than that of COPD-6 (0.91) and PEF (0.82). Subgroup analysis indicated that the accuracy of a multi-indices portable spirometer was higher than that of a single-index one (P < 0.05). In addition, portable spirometry performed by professional technicians in tertiary hospitals was more accurate than for those conducted by trained technicians in primary care facilities and communities (P < 0.05). Moreover, the accuracy of studies conducted in developing country was superior to developed country (P < 0.05). Portable spirometers have high accuracy in the diagnosis of COPD. Multi-index COPD-6 and PIKO-6 displayed higher accuracy than others. Standardized training of instrument operators should be considered to achieve reliable results.
Collapse
|
4
|
García Castillo E, Vargas G, García Guerra JA, López-Giraldo A, Alonso Pérez T. [Chronic Obstructive Pulmonary Disease]. OPEN RESPIRATORY ARCHIVES 2022; 4:100171. [PMID: 37497315 PMCID: PMC10369568 DOI: 10.1016/j.opresp.2022.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is related to smoking as the main etiological agent although there are other risk factors that can interact influencing the development of the disease. The definition of COPD is based on three points: the presence of persistent respiratory symptoms, exposure to risk agents, and a non-reversible obstructive spirometric ratio. Forced spirometry with a bronchodilator test is necessary to confirm the diagnosis of COPD, however, attempts are being made to develop alternative methods for screening given the current significant underdiagnosis of this pathology.In order to advance in a more personalized medicine for the patient, classification tools have been adopted such as clinical phenotypes and treatable traits, allowing treatments to be adapted according to the characteristics of the patients. Non-pharmacological treatment (smoking cessation, vaccination, physical exercise...) are essential for the management of the disease, as well as pharmacological treatment based on clinical phenotypes. Eosinophils have become a key marker when establishing treatment with inhaled glucocorticoids.In the follow-up of the disease, it is very relevant to evaluate the degree of control being a fundamental element the absence of exacerbations given their implications in mortality, morbidity and quality of life of patients. More studies are needed to better define the phenotypes of exacerbations and their biomarkers.
Collapse
Affiliation(s)
- Elena García Castillo
- Servicio de Neumología, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria La Princesa, Universidad Autónoma de Madrid (UAM), Madrid, España. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Gianna Vargas
- Servicio de Neumología, Hospital Universitario Clínico San Carlos, Madrid, España
| | | | | | - Tamara Alonso Pérez
- Servicio de Neumología, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria La Princesa, Universidad Autónoma de Madrid (UAM), Madrid, España. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| |
Collapse
|
5
|
Chen S, Li X, Wang Z, Zhou Y, Zhao D, Zhao Z, Liu S, Ran P. Validity of the Handheld Expiratory Flowmeter for COPD Screening in the Primary Care Setting of China. Int J Chron Obstruct Pulmon Dis 2021; 16:2039-2047. [PMID: 34267511 PMCID: PMC8275149 DOI: 10.2147/copd.s312190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/19/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The use of simple and affordable screening tools for chronic obstructive pulmonary disease (COPD) is limited. We aimed to assess the validity of a handheld expiratory flowmeter (Vitalograph Ltd., COPD-6®, Ireland) for COPD screening in Chinese primary care settings. Methods In our cross-sectional study, subjects were randomly selected in eight primary care settings. Tests with the handheld expiratory flowmeter and the conventional spirometry were sequentially performed on all participants. The correlation between the handheld expiratory flowmeter and the conventional spirometry was determined. Validity was determined by the area under the receiver operator characteristic curve (AUC) of the forced expiratory volume in one second (FEV1)/forced expiratory volume in six seconds (FEV6) that used to detect airway obstruction. The sensitivity, specificity, predictive values, and likelihood ratio were calculated according to different FEV1/FEV6 cut-off points. Results A total of 229 subjects (15.4%) were diagnosed with airflow limitation by conventional spirometry. FEV1, FEV6, and FEV1/FEV6 measured by the handheld expiratory flowmeter were correlated with FEV1, FVC, and FEV1/FVC measured by the conventional spirometry (r=0.889, 0.835 and 0.647, p<0.001), respectively. AUC of the FEV1/FEV6 to determine airflow obstruction was 0.857 (95% CI: 0.826 to 0.888). No significant difference of AUC was observed between the symptomatic group and the asymptomatic group (AUC=0.869 vs 0.843, P=0.425). A similar phenomenon was found in the AUC of smokers and never-smokers (AUC=0.862 vs 0.840; P=0.515). The cut-off point for FEV1/FEV6 was 0.77 and the corresponding sensitivity and specificity were 71.2% and 89.8%, respectively. Conclusion The handheld expiratory flowmeter might be used as a screening device for COPD in Chinese primary care settings.
Collapse
Affiliation(s)
- Shuyun Chen
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China.,Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Xiaochen Li
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China.,The People's Hospital of Hubei Province, Wuhan, Hubei Province, People's Republic of China
| | - Zihui Wang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Dongxing Zhao
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhuxiang Zhao
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China.,The First People's Hospital of Guangzhou City, Guangzhou, Guangdong Province, People's Republic of China
| | - Sha Liu
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease Guangzhou, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| |
Collapse
|
6
|
Hansen WAH, Schlünssen V, Jørs E, Sekabojja D, Ssempebwa JC, Mubeezi R, Staudacher P, Fuhrimann S, Hansen MRH. Precision and accuracy of FEV1 measurements from the Vitalograph copd-6 mini-spirometer in a healthy Ugandan population. PLoS One 2021; 16:e0253319. [PMID: 34181689 PMCID: PMC8238209 DOI: 10.1371/journal.pone.0253319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 06/03/2021] [Indexed: 12/17/2022] Open
Abstract
Objective Evaluate the accuracy and precision of the copd-6 mini-spirometer for FEV1 in a rural Ugandan population. Methods In a cross-sectional study, 171 smallholder farmers performed spirometry with copd-6, and a diagnostic-quality spirometer. Results and discussion The copd-6 underestimated FEV1 at low flows and overestimated FEV1 at high flows. Across all participants, the device slightly overestimated FEV1 by 0.04 [0.02; 0.06] L. Calibration data showed similar patterns. Conclusion The copd-6 could be considered as an affordable tool for research on lung function impairment in resource-constrained settings. However, further validation in a study population with obstructive lung disease is needed.
Collapse
Affiliation(s)
- Wajd Abbas Hassan Hansen
- Lægerne i Hirtshals APS, Hirtshals, Denmark
- Research Unit for Environment, Work and Health, Danish Ramazzini Center, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Vivi Schlünssen
- Research Unit for Environment, Work and Health, Danish Ramazzini Center, Department of Public Health, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Erik Jørs
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
- Occupational and Environmental Medicine, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Daniel Sekabojja
- Uganda National Association of Community and Occupational Health, Kampala, Uganda
| | | | - Ruth Mubeezi
- School of Public Health, Makerere University, Kampala, Uganda
| | - Philipp Staudacher
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
- Institute of Biogeochemistry and Pollutant Dynamics, ETH Zurich, Zurich, Switzerland
| | - Samuel Fuhrimann
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Martin Rune Hassan Hansen
- Research Unit for Environment, Work and Health, Danish Ramazzini Center, Department of Public Health, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
- * E-mail:
| |
Collapse
|
7
|
Alcázar-Navarrete B, Echave-Sustaeta JM. Microspirometers in the Follow-Up of COPD: Advantages and Disadvantages. Arch Bronconeumol 2020; 57:160-161. [PMID: 32798006 DOI: 10.1016/j.arbres.2020.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Bernardino Alcázar-Navarrete
- Hospital de Alta Resolución de Loja, Agencia Sanitaria Hospital de Poniente, Loja, Granada, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Jose María Echave-Sustaeta
- Hospital Universitario Quirónsalud Madrid, Madrid, España; Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| |
Collapse
|
8
|
Huguet-Rodríguez M, Arias-Buría JL, Huguet-Rodríguez B, Blanco-Barrero R, Braña-Sirgo D, Güeita-Rodríguez J. Impact of Aquatic Exercise on Respiratory Outcomes and Functional Activities in Children with Neuromuscular Disorders: Findings from an Open-Label and Prospective Preliminary Pilot Study. Brain Sci 2020; 10:brainsci10070458. [PMID: 32708972 PMCID: PMC7407397 DOI: 10.3390/brainsci10070458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 01/08/2023] Open
Abstract
Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4-18 years, Vignos scale 1-9) were involved in a 10-week aquatic exercise program. The ventilation variables were: peak cough flow, volumes (forced expiratory volume in one second-FEV1 and inspiratory volume) and respiratory pressures to evaluate strength and oxygen saturation (O2 sat). Functional skills were measured in the aquatic environment (Water Orientation Test Alyn 1) and on dry land, (Pediatric Evaluation of Disability Inventory), together with quality of life (Pediatric Quality of Life Inventory). Our evaluation included several 2 × 6 mixed-model repeated measures analysis of covariance (ANCOVA) with time (baseline, post 1 session, pre-post at five weeks and pre-post at 10 weeks). Important improvements in functional skills were observed in and out of the water and children under the age of 11 displayed a significant difference for inspirational volume (p = 0.002) and O2 sat (p = 0.029). Clinical, statistically insignificant changes were found for peak cough flow and expiratory pressures values after aquatic exercise. These results may support a relationship between aquatic exercise in NMD, respiratory outcomes and functional activities in water and on land.
Collapse
Affiliation(s)
- Marta Huguet-Rodríguez
- San José Institute Foundation, aquatic therapy unit, 28054 Madrid, Spain; (M.H.-R.); (R.B.-B.); (D.B.-S.)
| | - José Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain;
| | | | - Rocío Blanco-Barrero
- San José Institute Foundation, aquatic therapy unit, 28054 Madrid, Spain; (M.H.-R.); (R.B.-B.); (D.B.-S.)
| | - Daniel Braña-Sirgo
- San José Institute Foundation, aquatic therapy unit, 28054 Madrid, Spain; (M.H.-R.); (R.B.-B.); (D.B.-S.)
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain;
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum & QRinHS), Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-91-488-86-00
| |
Collapse
|
9
|
|
10
|
Ogasawara H, Hashimoto H. Relationship between maternal communicative/critical health literacy and child's asthma symptoms: Results from a population-based survey in metropolitan Japan. PATIENT EDUCATION AND COUNSELING 2020; 103:999-1004. [PMID: 31813711 DOI: 10.1016/j.pec.2019.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To examine the association between maternal communicative/critical health literacy (CCHL) and child's asthma symptoms. METHODS In a population-based survey in greater Tokyo (N = 790 mother-child [aged 2-11 years] pairs), maternal CCHL was assessed with a validated questionnaire, and the presence of asthma symptoms in children was assessed by parent report using the International Study of Asthma and Allergies in Childhood score. Multiple logistic regression was conducted to analyze the association between child's asthma and maternal health literacy, adjusting for potential confounders. RESULTS The prevalence of child's asthma in the past year was significantly higher in the high maternal CCHL group than in the low CCHL group (18.0% vs 12.3%,p;0.035). High maternal CCHL was positively associated with the presence of child's asthma symptoms after adjusting for the child's clinical factors; household income; and maternal educational attainment, psychological distress, and employment status (coefficient = 0.494, 95% confidence interval: 0.012-0.976). CONCLUSION High maternal CCHL does not necessarily lead to appropriate asthma control in children. CCHL's role in information overload environments requires further investigation. PRACTICE IMPLICATIONS Health care practitioners should provide support even to parents with high CCHL to enable them to make appropriate decisions.
Collapse
Affiliation(s)
- Hisako Ogasawara
- Department of Health and Social Behavior, the University of Tokyo School of Public Health, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, the University of Tokyo School of Public Health, Japan.
| |
Collapse
|
11
|
García-Ortiz JD, Cardona-Jiménez JL, Quijano-Almeida YM. La evaluación con el cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD - 6 como estrategia para el diagnóstico temprano de la EPOC en la atención primaria. IATREIA 2019. [DOI: 10.17533/udea.iatreia.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objetivo: evaluar el uso del cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD-6, como estrategia para el diagnóstico temprano de la enfermedad pulmonar obstructiva crónica (EPOC) en dos unidades de atención primaria de la empresa social del estado (E.S.E): Metrosalud, Medellín-Colombia en 2017. Métodos: estudio transversal de detección temprana de la EPOC, en personas mayores de 35 años sin diagnóstico previo de la enfermedad u otras complicaciones respiratorias subyacentes, a las cuales se les aplicó la prueba de tamizaje de COPD-PS para identificar factores de riesgo respiratorio y, posteriormente, la prueba de volumen espiratorio forzado (VEF1/VEF6) con el dispositivo portátil Vitalograph COPD-6. Resultados: de 1.485 pruebas de tamizaje COPD-PS, 198 presentaron un puntaje igual o superior a 4, por lo que se les realizó la prueba con el dispositivo Vitalograph. De los cuales, 147 (74,2 %) resultaron positivos. Discusión: el subregistro de la EPOC se describe actualmente como un grave problema mundial. El uso del cuestionario COPD-PS para la identificación de pacientes con factores de riesgo y del Vitalograph COPD-6 como prueba de función pulmonar, pueden ser herramientas útiles para implementar una estrategia efectiva en la reducción del subregistro de la EPOC.
Collapse
|
12
|
Effects of Smoking and Physical Activity on the Pulmonary Function of Young University Nursing Students in Cáceres (Spain). J Nurs Res 2019; 27:e46. [PMID: 30925523 PMCID: PMC6752695 DOI: 10.1097/jnr.0000000000000322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: The simultaneous effect of physical activity (PA) and smoking on pulmonary function in young people remains unclear. Propose: The aim of this study was to determine the influence of smoking and PA on pulmonary function in young university students in Cáceres, Spain. Methods: A sample of 120 young nursing students was studied (60 smokers and 60 nonsmokers). All subjects underwent spirometry with a COPD-6 portable device, and their level of PA was quantified using the International Physical Activity Questionnaire. The influence of PA and smoking on pulmonary function was determined by comparing hypotheses. Results: Significant differences were observed between smokers and nonsmokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and the difference between lung age and chronological age (LA–CA) in those who practiced mild PA. In the subjects who performed moderate and vigorous PA, these differences were not noted. In the intragroup analysis, significant differences were observed in smokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and LA–CA; however, in the control group, differences were only observed in terms of lung age and LA–CA. These findings were confirmed in the multivariate analysis. Conclusions/Implications for Practice: Our findings confirmed a deterioration in pulmonary function in smokers who did not perform moderate or vigorous PA. The level of PA performed was positively related to pulmonary function in smokers, whereas in nonsmokers, improvements were only significant in LA–CA.
Collapse
|
13
|
Hidalgo Sierra V, Hernández Mezquita MÁ, Palomo Cobos L, García Sánchez M, Diego Castellanos R, Jodra Sánchez S, Cordovilla Pérez R, Barrueco Ferrero M. Usefulness of the Piko-6 Portable Device for Early COPD Detection in Primary Care. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.arbr.2018.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Amemiya A, Fujiwara T. Association of Low Family Income With Lung Function Among Children and Adolescents: Results of the J-SHINE Study. J Epidemiol 2018; 29:50-56. [PMID: 29962491 PMCID: PMC6336726 DOI: 10.2188/jea.je20170220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The respiratory tract of children in low-income families is more likely to be exposed to toxins, which may lead to poor lung function. The purpose of this study was to elucidate the impact of low household income on lung function among children and adolescents in Japan. Methods We analyzed a population-based sample of 1,224 children aged 5 to 17 years old from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Forced expiratory volume in 1 s (FEV1) and in 6 s (FEV6) was measured. Annual household income and other potential covariates were assessed through a questionnaire. Low household income was defined as less than 3 million yen (approximately 27,000 United States dollars [USD]) per year. Multivariate regression analysis was used to adjust for potential covariates. Results We observed statistically significantly lower FEV1:FEV6 ratio with children in lowest-income families compared with those in highest-income families, after adjusting for child’s age and sex (coefficient = −0.082; 95% confidence interval [CI], −0.131 to −0.034). After adjusting for other covariates, including parental smoking status and parental diagnosis of asthma, a similar trend remained (coefficient = −0.054; 95% CI, −0.109 to 0.001). Conclusions Children in low-income families showed significantly lower lung function than those in high-income families. Prevention and early intervention are necessary to help the development of lung function among children living in low-income families.
Collapse
Affiliation(s)
- Airi Amemiya
- Department of Social Medicine, National Research Institute for Child Health and Development
| | - Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development.,Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU)
| |
Collapse
|
15
|
Usefulness of The Piko-6 Portable Device for Early COPD Detection in Primary Care. Arch Bronconeumol 2018; 54:460-466. [PMID: 29880313 DOI: 10.1016/j.arbres.2018.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION COPD is a highly prevalent but underdiagnosed disease, due to the limited availability of forced spirometry (FS) in primary care (PC). Microspirometers are inexpensive, easy-to-use devices that can measure FEV6 and FEV1/FEV6, and may help reduce underdiagnosis. The aim of this study was to validate the Piko-6 COPD screening device by demonstrating a good correlation with standard FS. METHODS FS and Piko-6 determinations were made in 155 patients suspected of having COPD. The correlations, ROC curves, and Youden's index of both methods were compared, taking FS as the gold standard. RESULTS FEV1, FVC and FEV6 correlation coefficients and FEV1/FVC and FEV1/FEV6 ratios were 0.87 (CI 0.836-0.909), 0.729 (CI 064-0.795) and 0.947 (95% CI 0.928-0.961), respectively. The ROC curve for FEV1 determined by Piko-6 achieved an area under the curve of 0.86 (95% CI: 0.78-0.92). Youden's index with a cut-off point of 0.70 for FEV1/FEV6 was 0.97. CONCLUSIONS Piko-6 may be useful for COPD screening in PC. Measurements obtained with this device correlate well with those determined by FS, particularly the FEV1/FEV6 ratio. This, combined with its low cost and ease of use, may contribute to reducing COPD underdiagnosis, although its exact role in the diagnostic process remains to be determined.
Collapse
|
16
|
Ramos Hernández C, Núñez Fernández M, Pallares Sanmartín A, Mouronte Roibas C, Cerdeira Domínguez L, Botana Rial MI, Blanco Cid N, Fernández Villar A. Validation of the portable Air-Smart Spirometer. PLoS One 2018; 13:e0192789. [PMID: 29474502 PMCID: PMC5825056 DOI: 10.1371/journal.pone.0192789] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/30/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Air-Smart Spirometer is the first portable device accepted by the European Community (EC) that performs spirometric measurements by a turbine mechanism and displays the results on a smartphone or a tablet. METHODS In this multicenter, descriptive and cross-sectional prospective study carried out in 2 hospital centers, we compare FEV1, FVC, FEV1/FVC ratio measured with the Air Smart-Spirometer device and a conventional spirometer, and analyze the ability of this new portable device to detect obstructions. Patients were included for 2 consecutive months. We calculate sensitivity, specificity, positive and negative predictive value (PPV and NPV) and likelihood ratio (LR +, LR-) as well as the Kappa Index to evaluate the concordance between the two devices for the detection of obstruction. The agreement and relation between the values of FEV1 and FVC in absolute value and the FEV1/FVC ratio measured by both devices were analyzed by calculating the intraclass correlation coefficient (ICC) and the Pearson correlation coefficient (r) respectively. RESULTS 200 patients (100 from each center) were included with a mean age of 57 (± 14) years, 110 were men (55%). Obstruction was detected by conventional spirometry in 73 patients (40.1%). Using a FEV1/FVC ratio smaller than 0.7 to detect obstruction with the Air Smart-Spirometer, the kappa index was 0.88, sensitivity (90.4%), specificity (97.2%), PPV (95.7%), NPV (93.7%), positive likelihood ratio (32.29), and negative likelihood ratio (0.10). The ICC and r between FEV1, FVC, and FEV1 / FVC ratio measured by the Air Smart Spirometer and the conventional spirometer were all higher than 0.94. CONCLUSION The Air-Smart Spirometer is a simple and very precise instrument for detecting obstructive airway diseases. It is easy to use, which could make it especially useful non-specialized care and in other areas.
Collapse
Affiliation(s)
- Cristina Ramos Hernández
- Department of Pneumonology, University Hospital Complex of Vigo, Pontevedra, Spain
- Neumo Vigo I + i. Institute of Health Research South Galicia (IISGS), Vigo, Pontevedra, Spain
| | | | | | - Cecilia Mouronte Roibas
- Department of Pneumonology, University Hospital Complex of Vigo, Pontevedra, Spain
- Neumo Vigo I + i. Institute of Health Research South Galicia (IISGS), Vigo, Pontevedra, Spain
| | | | - Maria Isabel Botana Rial
- Department of Pneumonology, University Hospital Complex of Vigo, Pontevedra, Spain
- Neumo Vigo I + i. Institute of Health Research South Galicia (IISGS), Vigo, Pontevedra, Spain
| | - Nagore Blanco Cid
- Department of Pneumonology, Hospital Complex of Pontevedra, Vigo, Pontevedra, Spain
| | - Alberto Fernández Villar
- Department of Pneumonology, University Hospital Complex of Vigo, Pontevedra, Spain
- Neumo Vigo I + i. Institute of Health Research South Galicia (IISGS), Vigo, Pontevedra, Spain
| |
Collapse
|
17
|
Figueira Gonçalves JM, Pérez Méndez LI, Guzmán Sáenz C, Díaz Pérez D, Viña Manrique P, Pedrero García AJ. Impact of body mass index on the predictive capacity of the COPD-6 device in the detection of airflow obstruction. Med Clin (Barc) 2017; 149:483-487. [PMID: 28669515 DOI: 10.1016/j.medcli.2017.05.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/09/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVE The portable COPD-6 device has been validated as a screening tool for airflow obstruction through the quantification of the FEV1/FEV6 ratio. To date, however, the impact of body mass index (BMI) on its ability to predict airflow obstruction has not been evaluated. The aim of the study was to assess the predictive ability of COPD-6 to detect airflow obstruction based on the patient's BMI. MATERIAL AND METHOD A prospective and open cohort study in which 223 subjects who underwent conventional spirometry and COPD-6 were included. The area under the curve ROC (AUC) of FEV1/FEV6 was analysed in the detection of obstruction for all patients in addition to BMI (BMI<30kg/m2 and BMI≥30kg/m2). Sensitivity and specificity, negative and positive predictive value as well as likelihood ratio were calculated to determine the cut-off point of COPD-6 FEV1/FEV6 ratio with greater predictive capacity. RESULTS The COPD-6 allows ruling out airflow obstruction with AUC of the estimated ROC curve of 88% (95% CI 83-93). The cut-off point FEV1/FEV6 of 0.74-0.76 shows the best predictive capacity. However, this capacity is altered according to BMI with an increase in false positives in subjects with BMI≥30kg/ m2 when using the same cut-off point for the whole sample. CONCLUSION The choice of cut-off point FEV1/FEV6 for the detection of obstruction should be adjusted to the patient's BMI.
Collapse
Affiliation(s)
- Juan Marco Figueira Gonçalves
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de la Candelaria (HUNSC), Santa Cruz de Tenerife, España.
| | - Lina Inmaculada Pérez Méndez
- Unidad de Investigación, Departamento de Epidemiología Clínica y Bioestadística, Hospital Universitario Nuestra Señora de Candelaria, Gerencia de Atención Primaria, Santa Cruz de Tenerife, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España
| | - Cristina Guzmán Sáenz
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de la Candelaria (HUNSC), Santa Cruz de Tenerife, España
| | - David Díaz Pérez
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de la Candelaria (HUNSC), Santa Cruz de Tenerife, España
| | - Pedro Viña Manrique
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de la Candelaria (HUNSC), Santa Cruz de Tenerife, España
| | - Arturo José Pedrero García
- Unidad de Investigación, Departamento de Epidemiología Clínica y Bioestadística, Hospital Universitario Nuestra Señora de Candelaria, Gerencia de Atención Primaria, Santa Cruz de Tenerife, España; Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España
| |
Collapse
|
18
|
Figueira Gonçalves JM, Pérez Rodríguez A. [COPD: the great unknown? A note on how to improve diagnostic accuracy]. REVISTA DE CALIDAD ASISTENCIAL : ORGANO DE LA SOCIEDAD ESPANOLA DE CALIDAD ASISTENCIAL 2017; 32:350-352. [PMID: 29055684 DOI: 10.1016/j.cali.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/22/2017] [Accepted: 08/27/2017] [Indexed: 06/07/2023]
Affiliation(s)
- J M Figueira Gonçalves
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de La Candelaria (HUNSC), Santa Cruz de Tenerife, Tenerife, España.
| | - A Pérez Rodríguez
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de La Candelaria (HUNSC), Santa Cruz de Tenerife, Tenerife, España
| |
Collapse
|
19
|
Kjeldgaard P, Lykkegaard J, Spillemose H, Ulrik CS. Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care? Int J Chron Obstruct Pulmon Dis 2017; 12:2323-2331. [PMID: 28831249 PMCID: PMC5552156 DOI: 10.2147/copd.s136244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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.
Collapse
Affiliation(s)
| | - Jesper Lykkegaard
- Research Unit of General Practice, University of Southern Denmark, Odense
| | | | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
20
|
Proceso de la atención inicial al paciente con EPOC. Estrategias de cribado. Arch Bronconeumol 2017. [DOI: 10.1016/s0300-2896(17)30359-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Llordés M, Zurdo E, Jaén Á, Vázquez I, Pastrana L, Miravitlles M. Which is the Best Screening Strategy for COPD among Smokers in Primary Care? COPD 2016; 14:43-51. [PMID: 27797591 DOI: 10.1080/15412555.2016.1239703] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We developed a questionnaire to detect cases of chronic obstructive pulmonary disease (COPD) and compared its reliability with other strategies. In order to develop the new questionnaire (COPD screening questionnaire from Terrassa [EGARPOC]) we used data from an epidemiological study on the prevalence of COPD in smokers and calculated the odds ratio for each variable showing significance for the diagnosis of COPD on regression analysis. For comparison among questionnaires and the portable spirometer COPD-6, a cross-sectional multicenter study was performed. The study included 407 smokers or ex-smokers over the age of 40 years with no known diagnosis of COPD, who completed the different questionnaires (EGARPOC, Respiratory Health Screening Questionnaire, COPD-population screener and 2 questions) and underwent spirometry with the COPD-6. We determined the sensitivity, specificity, positive and negative predictive values (S, Sp, PPV and NPV, respectively) and the area under the receiver operating characteristic ROC curve (AUC ROC) of all the questionnaires and the different COPD-6 cut-offs. The prevalence of COPD was 26.3%. The EGARPOC questionnaire showed an S of 81.8%, an Sp of 70.6%, and an NPV of 91.8%; 73.3% of individuals were correctly classified, and the AUC ROC was 0.841. On comparing the questionnaires by the Chi-square test, the 2-question questionnaire showed the worst discrimination; while with an optimal cut-off of forced expiratory volume in one 1 second (FEV1)/FEV6 of 0.78, the COPD-6 was significantly better than the questionnaires in the detection of COPD. Using a cut-off of FEV1/FEV6 of 0.78 the COPD-6 was found to be the best screening tool for COPD in primary care compared to the questionnaires tested, which did not show differences among them.
Collapse
Affiliation(s)
- Montserrat Llordés
- a CAP Terrassa Sud. Hospital Universitario Mutua de Terrassa, Universidad de Barcelona , Barcelona , Spain
| | - Elba Zurdo
- a CAP Terrassa Sud. Hospital Universitario Mutua de Terrassa, Universidad de Barcelona , Barcelona , Spain
| | - Ángeles Jaén
- b Coordinació projectes recerca, Fundació Docència i Recerca Mutua de Terrassa , Terrassa , Spain
| | - Inmaculada Vázquez
- a CAP Terrassa Sud. Hospital Universitario Mutua de Terrassa, Universidad de Barcelona , Barcelona , Spain
| | - Luís Pastrana
- c CAP Terrassa Oest. Hospital Universitario Mutua de Terrassa, Universidad de Barcelona , Barcelona , Spain
| | - Marc Miravitlles
- d Pneumology Department , Hospital Universitari Vall d'Hebron, CIBER de Enfermedades Respiratorias (CIBERES) , Barcelona , Spain
| |
Collapse
|
22
|
Uso del Vitalograph COPD-6 en atención primaria como herramienta para la deshabituación tabáquica. Semergen 2016; 42:75-80. [DOI: 10.1016/j.semerg.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 11/20/2022]
|
23
|
Kardos P, Schütt T, Mück T, Schumacher H, Michel MC. Pathophysiological Factors in the Relationship between Chronological Age and Calculated Lung Age as Detected in a Screening Setting in Community-Dwelling Subjects. Front Med (Lausanne) 2016; 3:2. [PMID: 26870734 PMCID: PMC4737876 DOI: 10.3389/fmed.2016.00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/12/2016] [Indexed: 11/20/2022] Open
Abstract
Aim To explore the relationship between pathophysiological factors and premature lung aging in a cohort of community-dwelling subjects in a health-screening setting. Methods 16,107 pharmacy customers in Germany (5954 males, 10,153 females; mean age 59.7 years) participated in a lung function screening project by providing demographic data, including smoking status and known airway conditions and performing spirometry with a Vitalograph, a spirometry screening device. Lung age was calculated from the spirometric findings, and the difference between chronological age and calculated lung age was analyzed in its relationship to the demographic data in general linear models. Results In the overall cohort, calculated lung age exceeded chronological age by 10.0 years. Based on the subset of non-smokers not reporting any airway conditions, Vitalograph data in this setting may underestimate FEV1 to some degree, but this apparently had little impact on the detection of association of lung age with pathophysiological factors or the corresponding effect sizes. The most important factors associated with greater lung age based on strength of association were presence of dyspnea, being a smoker, and reporting a history of COPD or asthma. Corresponding effect sizes for the difference between age and lung age were 6.5, 5.7, 13.9, and 8.3 years over the chronological age. Discussion and Conclusion These data confirm the usefulness of screening devices of lung function testing for epidemiological but potentially also for pharmaco-epidemiological studies.
Collapse
Affiliation(s)
- Peter Kardos
- Group Practice, Center for Allergy, Respiratory and Sleep Medicine, Red Cross Maingau Hospital , Frankfurt am Main , Germany
| | - Tanja Schütt
- Department of Medical Affairs, Boehringer Ingelheim Pharma GmbH & Co KG , Ingelheim , Germany
| | - Tobias Mück
- Department of Medical Affairs, Boehringer Ingelheim Pharma GmbH & Co KG , Ingelheim , Germany
| | | | - Martin C Michel
- Department of Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co KG, Ingelheim, Germany; Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany
| |
Collapse
|
24
|
Represas-Represas C, Fernández-Villar A, Ruano-Raviña A, Priegue-Carrera A, Botana-Rial M. Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings. PLoS One 2016; 11:e0145571. [PMID: 26726887 PMCID: PMC4699810 DOI: 10.1371/journal.pone.0145571] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 12/04/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction and Objectives The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings. Methods Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh). Study population: individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis. Results 437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performancein the different settings and also regarding age, gender and smoking status. Conclusions The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8.
Collapse
Affiliation(s)
- Cristina Represas-Represas
- Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain
- * E-mail:
| | - Alberto Fernández-Villar
- Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain
| | - Alberto Ruano-Raviña
- Department of Preventive Medicine and PublicHealth, University of Santiago de Compostela, Santiago de Compostela, Spain, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Ana Priegue-Carrera
- Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain
| | - Maribel Botana-Rial
- Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain
| | | |
Collapse
|
25
|
Sui CF, Ming LC, Neoh CF, Ibrahim B. VitalQPlus: a potential screening tool for early diagnosis of COPD. Int J Chron Obstruct Pulmon Dis 2015; 10:1613-22. [PMID: 26316735 PMCID: PMC4541542 DOI: 10.2147/copd.s84618] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study utilized a validated combination of a COPD Population Screener (COPD-PS) questionnaire and a handheld spirometric device as a screening tool for patients at high risk of COPD, such as smokers. The study aimed to investigate and pilot the feasibility and application of this combined assessment, which we termed the "VitalQPlus", as a screening tool for the early detection of COPD, especially in primary care settings. METHODS This was a cross-sectional study screening potentially undiagnosed COPD patients using a validated five-item COPD-PS questionnaire together with a handheld spirometric device. Patients were recruited from selected Malaysian government primary care health centers. RESULTS Of the total of 83 final participants, only 24.1% (20/83) were recruited from Perak and Penang (peninsular Malaysia) compared to 75.9% (63/83) from Sabah (Borneo region). Our dual assessment approach identified 8.4% of the surveyed patients as having potentially undiagnosed COPD. When only the Vitalograph COPD-6 screening tool was used, 15.8% of patients were detected with a forced expiratory volume in 1 second/forced expiratory volume in 6 seconds (FEV1/FEV6) ratio at <0.75, while 35.9% of patients were detected with the COPD-PS questionnaire. These findings suggested that this dual assessment approach has a greater chance of identifying potentially undiagnosed COPD patients compared to the Vitalograph COPD-6 or COPD-PS questionnaire when used alone. Our findings show that patients with more symptoms (scores of ≥5) yielded twice the percentage of outcomes of FEV1/FEV6 <0.75 compared to patients with fewer COPD symptoms (scores <5). CONCLUSION With the availability of a simple screening questionnaire and the COPD-6, there is an opportunity easily to make patients more aware of their lung symptoms and to encourage the provision of early treatment. The proposed dual assessment approach, which we termed the VitalQPlus, may play a profound role in the early diagnosis of COPD, which is crucial in improving the clinical management of the disease.
Collapse
Affiliation(s)
- Chee Fai Sui
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Long Chiau Ming
- Faculty of Pharmacy, Universiti Teknologi MARA, UiTM, Selangor, Malaysia ; Brain Degeneration and Therapeutics Group, Pharmaceutical and Life Sciences (PLS) Community of Research (CoRe), UiTM, Selangor, Malaysia
| | - Chin Fen Neoh
- Faculty of Pharmacy, Universiti Teknologi MARA, UiTM, Selangor, Malaysia ; Collaborative Drug Discovery Research (CDDR) Group, Pharmaceutical and Life Sciences (PLS) Community of Research (CoRe), UiTM, Selangor, Malaysia
| | - Baharudin Ibrahim
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| |
Collapse
|
26
|
Efficient screening for COPD using three steps: a cross-sectional study in Mexico City. NPJ Prim Care Respir Med 2014; 24:14002. [PMID: 24841708 PMCID: PMC4373258 DOI: 10.1038/npjpcrm.2014.2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/15/2013] [Accepted: 01/14/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Underdiagnosis of chronic obstructive pulmonary disease (COPD) in primary care can be improved by a more efficient screening strategy. AIMS To evaluate a three-step method of screening for COPD consisting of an initial short questionnaire followed by measurement of forced expiratory volume in 1s/forced expiratory volume in 6s (FEV1/FEV6) using an inexpensive pocket spirometer in those with high risk, and diagnostic quality spirometry in those with a low FEV1/FEV6. METHODS We analysed two related Mexico City cross-sectional samples. The 2003 Mexico City PLATINO survey (n=542) was used to develop a short questionnaire to determine the risk of COPD and a 2010 survey (n=737) additionally used a pocket spirometer. The discriminatory power of the two instruments was assessed with receiver operator characteristic (ROC) curves using three COPD definitions. RESULTS The developed COPD scale included two variables from a simple questionnaire and, in ROC analysis, an area under the curve (AUC) between 0.64 and 0.77 was found to detect COPD. The pocket spirometer had an AUC between 0.85 and 0.88 to detect COPD. Using the COPD scale as a first screening step excluded 35-48% of the total population from further testing at the cost of not detecting 8-18% of those with COPD. Using the pocket spirometer and sending those with a FEV1/FEV6<0.80 for diagnostic quality spirometry is very efficient, and substantially improved the positive predictive value at the cost of not detecting one-third of COPD cases. CONCLUSIONS A three-step screening strategy for COPD substantially reduces the need for spirometry testing when only a COPD scale is used for screening.
Collapse
|
27
|
|
28
|
Serrano-Mollar A. [Alveolar epithelial cell injury as an etiopathogenic factor in pulmonary fibrosis]. Arch Bronconeumol 2012; 48 Suppl 2:2-6. [PMID: 23116901 PMCID: PMC7131261 DOI: 10.1016/s0300-2896(12)70044-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF) is characterized by a progressive accumulation of extracellular matrix and an imbalance between profibrotic and antifibrotic mediators. In the last few years, understanding of the mechanisms of the biology of IPF has increased. One of the most significant discoveries is the finding that alveolar epithelial cell injury plays an important role in the pathogenesis of this disease. In this review, we describe some of the mechanisms involved in alveolar cell injury and their contribution to the development of IPF.
Collapse
Affiliation(s)
- Anna Serrano-Mollar
- Departamento de Patología Experimental, Institut d'Investigacions Biomèdiques de Barcelona, España.
| |
Collapse
|
29
|
Albers F, Shaikh A, Iqbal A. Design, rationale, and baseline demographics of SEARCH I: a prospective cluster-randomized study. Int J Chron Obstruct Pulmon Dis 2012; 7:437-45. [PMID: 22848157 PMCID: PMC3402060 DOI: 10.2147/copd.s31418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Questionnaires are available to identify patients at risk for several chronic diseases, including COPD, but are infrequently utilized in primary care. COPD is often underdiagnosed, while at the same time the US Preventive Services Task Force recommends against spirometric screening for COPD in asymptomatic adults. Use of a symptom-based questionnaire and subsequent handheld spirometric device depending on the answers to the questionnaire is a promising approach to identify patients at risk for COPD. Screening, Evaluating and Assessing Rate CHanges of diagnosing respiratory conditions in primary care 1 (SEARCH I) was a prospective cluster-randomized study in 168 US primary care practices evaluating the effect of the COPD-Population Screener (COPD-PS™) questionnaire. The effect of this questionnaire alone or sequentially with the handheld copd-6TM device was evaluated on new diagnoses of COPD and on respiratory diagnostic practice patterns (including referrals for pulmonary function testing, referrals to pulmonologists, new diagnoses of COPD, and new respiratory medication prescriptions). Participating practices entered a total of 9704 consecutive consenting subjects aged ≥ 40 years attending primary care clinics. Study arm results were compared for new COPD diagnosis rates between usual care and (1) COPD-PS plus copd-6 and (2) COPD-PS alone. A cluster-randomization design allowed comparison of the intervention effects at the practice level instead of individuals being the subjects of the intervention. Regional principal investigators controlled the flow of study information to sub-investigators at participating practices to reduce observation bias (Hawthorne effect). The results of SEARCH I, to be published subsequently, will provide insight into the real world utility of the COPD-PS as well as two-stage COPD case finding with COPD-PS and copd-6.
Collapse
Affiliation(s)
- Frank Albers
- Medical Affairs Respiratory, Field Based Medicine-Respiratory, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT 06877, USA.
| | | | | |
Collapse
|
30
|
[Validation of the Spanish version of the Chronic Obstructive Pulmonary Disease-Population Screener (COPD-PS). Its usefulness and that of FEV₁/FEV₆ for the diagnosis of COPD]. Med Clin (Barc) 2011; 139:522-30. [PMID: 22015009 DOI: 10.1016/j.medcli.2011.06.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Revised: 06/23/2011] [Accepted: 06/28/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The chronic obstructive pulmonary disease (COPD) is a highly undiagnosed disease. The use of short screening questionnaires designed to detect chronic airflow obstruction may help to the early diagnosis of COPD. PATIENTS AND METHOD This was an observational, cross-sectional epidemiological study aimed to validate the translated into Spanish version of the COPD-PS questionnaire. Socio-demographic and clinical data of participants were collected, as well as their answers to the COPD-PS and EQ-5D questionnaires. The ratio FEV(1)/FEV(6) was measured with the COPD-6 device. The psychometric properties of the questionnaire and the diagnostic yield of the FEV(1)/FEV(6) ratio were analysed, both referred to the gold standard of post-bronchodilator FEV(1)/FVC < 0.7. RESULTS Ten primary care centers participated in the study and included 94 controls and 79 cases with chronic airflow obstruction. Questionnaire characteristics were: feasibility, 2.3% of participants did not answer at least one item; mean time to fill the questionnaire was 47.7 seconds; 4.7% of individuals had a 0 score. Validity, moderate correlation with EQ-5D scores and moderate-high with FEV(1); the scores of COPD-PS were related to all parameters associated with COPD. A cut off of 4 units had the best sensitivity/specificity ratio and correctly classified 78% of participants. For the FEV(1)/FEV(6) ratio, a cut off of 0.75 correctly classified 85% of individuals. CONCLUSIONS The COPD-PS questionnaire demonstrated good psychometric properties. A cut off score of 4 has excellent predictive value. A ratio of 0.75 in the FEV(1)/FEV(6) provides an excellent correlation with the ratio FEV(1)/FVC and is useful for the identification of individuals with chronic airflow obstruction.
Collapse
|
31
|
Gil-Guillén V, Orozco-Beltrán D, Carratala Munuera CV, Plaza-Sirvent C, Lorca-Amorrich P, López-Pineda A, Vela-Troncoso MP, Soler JJ, Yarza-Cañellas M, Fernández A, Rosado-Bretón L, Olivares-Bautista C, Muñoz-Fernández A. FUMEPOC: early detection of chronic obstructive pulmonary disease in smokers. BMC Public Health 2011; 11:413. [PMID: 21627787 PMCID: PMC3120686 DOI: 10.1186/1471-2458-11-413] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 05/31/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Currently is not feasible using conventional spirometry as a screening method in Primary Care especially among smoking population to detect chronic obstructive pulmonary disease in early stages. Therefore, the FUMEPOC study protocol intends to analyze the validity and reliability of Vitalograph COPD-6 spirometer as simpler tool to aid screening and diagnosis of this disease in early stages in primary care surgery. METHODS / DESIGN STUDY DESIGN An observational, descriptive study of diagnostic tests, undertaken in Primary Care and Pneumology Outpatient Care Centre at San Juan Hospital and Elda Hospital. All smokers attending the primary care surgery and consent to participate in the study will undergo a test with Vitalograph COPD-6 spirometer. Subsequently, a conventional spirometry will be performed in the hospital and the results will be compared with those of the Vitalograph COPD-6 test. DISCUSSION It is difficult to use the spirometry as screening for early diagnose test in real conditions of primary care clinical practice. The use of a simpler tool, Vitalograph COPD-6 spirometer, can help in the early diagnose and therefore, it could improve the clinical management of the disease.
Collapse
Affiliation(s)
- Vicente Gil-Guillén
- Departamento Medicina Clínica, Universidad Miguel Hernández de Elche (Campus de San Juan), 03550 San Juan de Alicante, Alicante, Spain
| | - Domingo Orozco-Beltrán
- Unidad Investigación, Hospital Universitario San Juan de Alicante, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d'Alacant (Alicante), Spain
| | - Concepcion V Carratala Munuera
- Departamento Medicina Clínica, Universidad Miguel Hernández de Elche, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d'Alacant (Alicante), Spain
| | - Carlos Plaza-Sirvent
- Unidad Investigación, Hospital Universitario San Juan de Alicante, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d'Alacant (Alicante), Spain
| | - Patricia Lorca-Amorrich
- Unidad Investigación, Hospital Universitario San Juan de Alicante, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d'Alacant (Alicante), Spain
| | - Adriana López-Pineda
- Unidad Investigación, Hospital Universitario San Juan de Alicante, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d'Alacant (Alicante), Spain
| | - María P Vela-Troncoso
- Departamento de Medicina Interna, Hospital General de Elda (Alicante), Ctra. Sax-Elda, s/n, 03600, Elda, Spain
| | - Juan J Soler
- Servicio de Neumología, Hospital de Requena, Casablanca, S/N, 46340, Requena, Spain
| | - Manuel Yarza-Cañellas
- Agencia Valenciana de Salud, Conselleria de Sanidad, Micer Mascó no 31, 46010, Valencia, Spain
| | - Antonio Fernández
- Unidad Investigación, Hospital Universitario San Juan de Alicante, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d'Alacant (Alicante), Spain
| | - Luis Rosado-Bretón
- Agencia Valenciana de Salud, Conselleria de Sanidad, Micer Mascó no 31, 46010, Valencia, Spain
| | | | | | | |
Collapse
|
32
|
|