Hidalgo Sierra Vanesa, Hernández Mezquita Miguel Ángel, Palomo Cobos Luis, García Sánchez Myriam, Castellanos Ramón Diego, Jodra Sánchez Soraya, Cordovilla Pérez Rosa, Barrueco Ferrero Miguel
Centro de Salud de Béjar, Salamanca, España.
Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España.
Arch Bronconeumol (Engl Ed). 2018 Sep;54(9):460-466. doi: 10.1016/j.arbres.2018.04.015. Epub 2018 Jun 5.
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 FEV and FEV/FEV, 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.
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.
FEV, FVC and FEV correlation coefficients and FEV/FVC and FEV/FEV 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 FEV 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.
Piko-6 may be useful for COPD screening in PC. Measurements obtained with this device correlate well with those determined by FS, particularly the FEV/FEV 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.
慢性阻塞性肺疾病（COPD）是一种高度流行但诊断不足的疾病，这是由于基层医疗（PC）中肺功能仪（FS）的可及性有限。微型肺功能仪是价格低廉、易于使用的设备，能够测量第一秒用力呼气容积（FEV）和FEV/用力肺活量（FVC），可能有助于减少漏诊。本研究的目的是通过证明与标准肺功能仪有良好的相关性来验证Piko-6慢性阻塞性肺疾病筛查设备。
对155例疑似患有慢性阻塞性肺疾病的患者进行了肺功能仪和Piko-6测定。以肺功能仪作为金标准，比较了两种方法的相关性、ROC曲线和尤登指数。
FEV、用力肺活量（FVC）和FEV的相关系数以及FEV/FVC和FEV/FEV比值分别为0.87（95%置信区间0.836 - 0.909）、0.729（95%置信区间0.64 - 0.795）和0.947（95%置信区间0.928 - 0.961）。Piko-6测定的FEV的ROC曲线下面积为0.86（95%置信区间：0.78 - 0.92）。FEV1/FEV6截断点为0.70时的尤登指数为0.97。
Piko-6可能有助于基层医疗中慢性阻塞性肺疾病的筛查。用该设备获得的测量值与肺功能仪测定的结果相关性良好，尤其是FEV/FEV比值。尽管其在诊断过程中的确切作用仍有待确定，但这一点与其低成本和易用性相结合，可能有助于减少慢性阻塞性肺疾病的漏诊。
