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在医疗体检人群中使用筛查问卷进行慢性阻塞性肺疾病的大规模筛查的效果。

The efficacy of mass screening for chronic obstructive pulmonary disease using screening questionnaires in a medical health check-up population.

机构信息

Department of Respiratory Medicine, Shikoku Central Hospital of the Mutual aid Association of Public School teachers, 2233 Kawanoe-cho, Shikoku-Chuo, 799-0193, Japan; Department of Community Medicine for Respirology, Hematology, and Metabolism, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.

Department of Respiratory Medicine, Shikoku Central Hospital of the Mutual aid Association of Public School teachers, 2233 Kawanoe-cho, Shikoku-Chuo, 799-0193, Japan.

出版信息

Respir Investig. 2022 Nov;60(6):815-821. doi: 10.1016/j.resinv.2022.07.005. Epub 2022 Aug 31.

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease, highlighting the need for efficient screening strategies to identify patients with COPD. However, there is little evidence regarding the efficacy of mass screening for COPD, and no epidemiological studies on COPD have been conducted in the Shikoku region of Japan.

METHODS

In this cross-sectional study, we originally investigated the efficacy of mass screening for COPD among community residents in the aforementioned region using two COPD screening questionnaires.

RESULTS

From July 2018 through January 2019, 688 participants were enrolled. COPD was diagnosed using the Global Initiative for the Chronic Obstructive Lung Disease criteria. Twenty-one patients were newly diagnosed with COPD and 19 (90.5%) had early stages COPD. The prevalence of COPD in this study was 3.1%. The COPD Population Screener (COPD-PS) questionnaire and the International Primary Care Airways Guidelines (IPAG) questionnaire had extremely high negative predictive values in discriminating participants with COPD from those without. The scores of both questionnaires were correlated with spirometric tests and with each other. The COPD-PS questionnaire had significantly better specificity and area under the receiver operating characteristic curve value than the IPAG questionnaire. Moreover, only the COPD-PS questionnaire was identified as an independent factor for predicting COPD diagnosis in the multivariate analysis.

CONCLUSIONS

Mass screening for COPD using screening questionnaires, particularly the COPD-PS questionnaire, might be useful to identify the early stages of COPD in a medical health check-up population.

摘要

背景

慢性阻塞性肺疾病(COPD)是一种可预防和可治疗的疾病,这凸显出需要有效的筛选策略来识别 COPD 患者。然而,关于 COPD 大规模筛查的疗效证据很少,日本四国地区也没有关于 COPD 的流行病学研究。

方法

在这项横断面研究中,我们最初使用两种 COPD 筛查问卷,调查了上述地区社区居民中 COPD 大规模筛查的效果。

结果

2018 年 7 月至 2019 年 1 月,共纳入 688 名参与者。使用全球慢性阻塞性肺疾病倡议(GOLD)标准诊断 COPD。21 例患者新诊断为 COPD,19 例(90.5%)为早期 COPD。本研究 COPD 的患病率为 3.1%。COPD 人群筛查器(COPD-PS)问卷和国际初级保健气道指南(IPAG)问卷在鉴别 COPD 患者和非 COPD 患者方面具有极高的阴性预测值。这两个问卷的评分都与肺功能测试和彼此相关。COPD-PS 问卷在鉴别 COPD 患者和非 COPD 患者方面具有显著更好的特异性和受试者工作特征曲线下面积值,优于 IPAG 问卷。此外,在多变量分析中,只有 COPD-PS 问卷被确定为预测 COPD 诊断的独立因素。

结论

使用筛查问卷对 COPD 进行大规模筛查,特别是 COPD-PS 问卷,可能有助于在医疗健康检查人群中识别早期 COPD。

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