Raval Health Centre, Generalitat Valenciana, Elche, Alicante, Spain.
Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Alicante, Spain.
Sci Rep. 2018 Sep 6;8(1):13329. doi: 10.1038/s41598-018-31198-8.
No validated screening method currently exists for Chronic Obstructive Pulmonary Disease (COPD) in smokers. Therefore, we constructed a predictive model with simple parameters that can be applied for COPD screening to detect fixed airflow limitation. This observational cross-sectional study included a random sample of 222 smokers with no previous diagnosis of COPD undertaken in a Spanish region in 2014-2016. The main variable was fixed airflow limitation by spirometry. The secondary variables (COPD factors) were: age, gender, smoking (pack-years and Fagerström test), body mass index, educational level, respiratory symptoms and exacerbations. A points system was developed to predict fixed airflow limitation based on secondary variables. The model was validated internally through bootstrapping, determining discrimination and calibration. The system was then integrated into a mobile application for Android. Fifty-seven patients (25.7%) presented fixed airflow limitation. The points system included as predictors: age, pack-years, Fagerström test and presence of respiratory symptoms. Internal validation of the system was very satisfactory, both in discrimination and calibration. In conclusion, a points system has been constructed to predict fixed airflow limitation in smokers with no previous COPD. This system can be integrated as a screening tool, though it should be externally validated in other geographical regions.
目前，吸烟者的慢性阻塞性肺疾病（COPD）尚无经过验证的筛查方法。因此，我们构建了一个具有简单参数的预测模型，可用于 COPD 筛查以检测固定气流受限。这项观察性横断面研究于 2014 年至 2016 年在西班牙的一个地区纳入了 222 名没有 COPD 既往诊断的随机吸烟者样本。主要变量是通过肺活量计测量的固定气流受限。次要变量（COPD 因素）包括：年龄、性别、吸烟（包年数和 Fagerström 测试）、体重指数、教育程度、呼吸症状和加重。根据次要变量开发了一个预测固定气流受限的评分系统。通过自举法、判别和校准对模型进行了内部验证。然后，该系统被整合到一个用于 Android 的移动应用程序中。57 名患者（25.7%）出现了固定气流受限。该评分系统包括的预测因子为：年龄、包年数、Fagerström 测试和呼吸症状的存在。该系统的内部验证结果非常令人满意，在判别和校准方面都表现出色。总之，我们构建了一个用于预测无既往 COPD 的吸烟者固定气流受限的评分系统。该系统可作为一种筛查工具集成使用，但应在其他地理区域进行外部验证。
