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.
Int J Chron Obstruct Pulmon Dis. 2023 Apr 10;18:541-552. doi: 10.2147/COPD.S403603. eCollection 2023.
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.
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.
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).
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.
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。
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。
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）。
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。
