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VitalQPlus:一种用于慢性阻塞性肺疾病早期诊断的潜在筛查工具。

VitalQPlus: a potential screening tool for early diagnosis of COPD.

作者信息

Sui Chee Fai, Ming Long Chiau, Neoh Chin Fen, Ibrahim Baharudin

机构信息

School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.

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.

出版信息

Int J Chron Obstruct Pulmon Dis. 2015 Aug 11;10:1613-22. doi: 10.2147/COPD.S84618. eCollection 2015.

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.

摘要

背景

本研究采用经过验证的慢性阻塞性肺疾病人群筛查问卷(COPD-PS)和手持式肺功能仪作为慢性阻塞性肺疾病高危患者(如吸烟者)的筛查工具。本研究旨在调查并试点这种联合评估(我们称之为“VitalQPlus”)作为慢性阻塞性肺疾病早期检测筛查工具的可行性和应用情况,尤其是在初级保健环境中。

方法

这是一项横断面研究,使用经过验证的五项COPD-PS问卷和手持式肺功能仪对潜在未确诊的慢性阻塞性肺疾病患者进行筛查。患者从选定的马来西亚政府初级保健健康中心招募。

结果

在总共83名最终参与者中,只有24.1%(20/83)来自霹雳州和槟城(马来西亚半岛),相比之下,75.9%(63/83)来自沙巴州(婆罗洲地区)。我们的双重评估方法确定8.4%的受调查患者可能患有未确诊的慢性阻塞性肺疾病。仅使用伟康慢性阻塞性肺疾病-6筛查工具时,15.8%的患者1秒用力呼气容积/6秒用力呼气容积(FEV1/FEV6)比值<0.75,而35.9%的患者通过COPD-PS问卷检测出患有慢性阻塞性肺疾病。这些结果表明,与单独使用伟康慢性阻塞性肺疾病-6或COPD-PS问卷相比,这种双重评估方法更有可能识别出潜在未确诊的慢性阻塞性肺疾病患者。我们的研究结果表明,症状较多(评分≥5)的患者FEV1/FEV6<0.75的结果百分比是慢性阻塞性肺疾病症状较少(评分<5)患者的两倍。

结论

有了简单的筛查问卷和慢性阻塞性肺疾病-6,就有机会让患者更容易了解自己的肺部症状,并鼓励提供早期治疗。我们提出的双重评估方法,即VitalQPlus,可能在慢性阻塞性肺疾病的早期诊断中发挥重要作用,这对改善该疾病的临床管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8af/4541542/a9e504418835/copd-10-1613Fig1.jpg

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