Department of Medicine, George Washington University School of Medicine, Washington, DC, USA.
Mayo Clin Proc. 2011 May;86(5):375-81. doi: 10.4065/mcp.2010.0787.
To estimate the prevalence of unidentified chronic obstructive pulmonary disease (COPD) and determine the screening accuracy of the Lung Function Questionnaire (LFQ).
Cigarette smokers who had a smoking history of 10 or more pack-years and were aged 30 years or older were recruited from 36 centers from February 18, 2009, to May 29, 2009. A total of 1575 patients completed a Web-based survey including the 5-item LFQ. Spirometry was performed on patients with an LFQ total score of 18 or less and on a subset scoring more than 18. The primary outcome was the proportion of patients at risk of airflow obstruction as measured by the LFQ (score, ≤ 18) in whom an airflow obstruction was confirmed by spirometry.
Of the patients who completed the LFQ, 849 (54%) had standardized spirometry data available. On the basis of LFQ and spirometry results, the estimated prevalence of possible COPD was 17.9% (95% confidence interval, 15.3%-20.6%). At a cut point of 18 or less, sensitivity, specificity, positive predictive value, and negative predictive value of the LFQ were 88%, 25%, 21%, and 90%, respectively. Approximately 1 in 5 patients (21%) aged 30 years or older and 1 in 4 (26%) aged 50 years or older scored 18 or less on the LFQ and had a ratio of forced expiratory volume in the first second of expiration to forced vital capacity less than 0.70.
On the basis of postbronchodilator spirometry results using weighted estimates, approximately 1 in 5 patients (21%) aged 30 years or older with a smoking history of 10 or more pack-years seen in a primary care setting is likely to have COPD. The LFQ could be a helpful COPD case-finding tool for clinicians to identify patients who need further evaluation.
clinicaltrials.gov Identifier: NCT01013948.
评估未明确的慢性阻塞性肺疾病（COPD）的患病率，并确定肺功能问卷（LFQ）的筛查准确性。
从 2009 年 2 月 18 日至 5 月 29 日，从 36 个中心招募了吸烟史为 10 年或以上、年龄在 30 岁或以上的吸烟者。共有 1575 名患者完成了一项基于网络的调查，其中包括 5 项 LFQ。对 LFQ 总分为 18 或以下的患者以及总分大于 18 的患者进行肺量计检查。主要结局是通过 LFQ（评分，≤18）测量处于气流阻塞风险的患者中，有多少患者的气流阻塞通过肺量计检查得到证实。
在完成 LFQ 的患者中，849 名（54%）有标准化的肺量计数据可用。根据 LFQ 和肺量计的结果，可能的 COPD 的估计患病率为 17.9%（95%置信区间，15.3%-20.6%）。在 18 或以下的切点处，LFQ 的敏感性、特异性、阳性预测值和阴性预测值分别为 88%、25%、21%和 90%。大约 1/5（21%）的 30 岁或以上患者和 1/4（26%）的 50 岁或以上患者的 LFQ 得分为 18 或以下，并且用力呼气量第一秒与用力肺活量的比值小于 0.70。
根据使用加权估计的支气管扩张后肺量计结果，在初级保健环境中看到的吸烟史为 10 年或以上、年龄在 30 岁或以上的患者中，大约有 1/5（21%）可能患有 COPD。LFQ 可能是临床医生识别需要进一步评估的患者的有用 COPD 病例发现工具。
clinicaltrials.gov 标识符：NCT01013948。
