比较两种用于中国一般人群的慢性阻塞性肺疾病筛查问卷的性能。
Comparing the Performance of Two Screening Questionnaires for Chronic Obstructive Pulmonary Disease in the Chinese General Population.
机构信息
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
出版信息
Int J Chron Obstruct Pulmon Dis. 2023 Apr 10;18:541-552. doi: 10.2147/COPD.S403603. eCollection 2023.
PURPOSE
Screening questionnaires can help identify individuals at a high risk of COPD. This study aimed to compare the performance of the COPD population screener (COPD-PS) and COPD screening questionnaire (COPD-SQ) on the general population as a full cohort and stratified by urbanization.
METHODS
We recruited subjects who underwent a health checkup at urban and rural community health centers in Beijing. All eligible subjects completed the COPD-PS and COPD-SQ, then spirometry. Spirometry-defined COPD was defined as a post-bronchodilator FEV/FVC<70%. Symptomatic COPD was defined as a post-bronchodilator FEV/FVC<70% and respiratory symptoms. Receiver operating characteristic (ROC) curve analysis compared the discriminatory power of the two questionnaires, and stratified by urbanization.
RESULTS
We identified 129 spirometry-defined and 92 symptomatic COPD cases out of 1350 enrolled subjects. The optimal cut-off score for the COPD-PS was 4 for spirometry-defined and 5 for symptomatic COPD. The optimum cut-off score for the COPD-SQ was 15 for both spirometry-defined and symptomatic COPD. The COPD-PS and COPD-SQ had similar AUC values for spirometry-defined (0.672 vs 0.702) and symptomatic COPD (0.734 vs 0.779). The AUC of the COPD-SQ tended to be higher in rural areas than that of the COPD-PS for spirometry-defined COPD (0.700 vs 0.653, = 0.093).
CONCLUSION
The COPD-PS and COPD-SQ had comparable discriminatory power for detecting COPD in the general population while the COPD-SQ performed better in rural areas. A pilot study for validating and comparing the diagnostic accuracy of different questionnaires is required when screening for COPD in a new environment.
目的
筛查问卷可帮助识别 COPD 高危人群。本研究旨在比较 COPD 人群筛查器（COPD-PS）和 COPD 筛查问卷（COPD-SQ）在一般人群中的表现，以及按城市化程度分层的表现。
方法
我们招募了在北京城市和农村社区卫生中心进行健康检查的受试者。所有符合条件的受试者均完成 COPD-PS 和 COPD-SQ 问卷，然后进行肺量测定。支气管扩张剂后 FEV/FVC<70%定义为肺量测定定义的 COPD。有症状的 COPD 定义为支气管扩张剂后 FEV/FVC<70%和呼吸系统症状。接收者操作特征（ROC）曲线分析比较了两种问卷的鉴别能力，并按城市化程度分层。
结果
我们从 1350 名入组受试者中确定了 129 例肺量测定定义的 COPD 和 92 例有症状的 COPD 病例。COPD-PS 的最佳截断值为肺量测定定义的 4 分和有症状的 COPD 的 5 分。COPD-SQ 的最佳截断值为肺量测定定义的和有症状的 COPD 均为 15 分。COPD-PS 和 COPD-SQ 对肺量测定定义的 COPD（0.672 对 0.702）和有症状的 COPD（0.734 对 0.779）的 AUC 值相似。COPD-SQ 在农村地区的 AUC 高于 COPD-PS 对于肺量测定定义的 COPD（0.700 对 0.653， = 0.093）。
结论
COPD-PS 和 COPD-SQ 对一般人群中 COPD 的检测具有相当的鉴别能力，而 COPD-SQ 在农村地区的表现更好。在新环境中进行 COPD 筛查时，需要进行验证和比较不同问卷诊断准确性的试点研究。
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