CAD-Q（慢性阻塞性肺疾病-哮喘鉴别问卷）：一种用于区分成人慢性阻塞性肺疾病和哮喘的新诊断评分方法的性能

CAD-Q (COPD-Asthma Differentiation Questionnaire): Performance of a new diagnostic score to differentiate between COPD and asthma in adults.

作者信息

Lozano-Forero Alejandra, Tuta-Quintero Eduardo, Bastidas Alirio R, Pacheco Blanka, Cordero Juan, Faizal Kamil, Molina Miguel, Méndez Irma, Cardona Andrés, Navarro Nicoll, Bonilla Gabriela, Franco Manuela, Samboní Juan, Hoz Julio de La, Doumat Georgina, Portilla David, Eljach Hannah

机构信息

Master's Student in Epidemiology, Universidad de La Sabana, Chía, Colombia.

School of Medicine, Universidad de La Sabana, Chía, Colombia.

出版信息

BMC Pulm Med. 2025 Jan 15;25(1):20. doi: 10.1186/s12890-025-03492-5.

DOI:10.1186/s12890-025-03492-5

PMID:39815228

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11734519/

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) and asthma are the two most prevalent chronic respiratory diseases, significantly impacting public health. Utilizing clinical questionnaires to identify and differentiate patients with COPD and asthma for further diagnostic procedures has emerged as an effective strategy to address this issue. We developed a new diagnostic tool, the COPD-Asthma Differentiation Questionnaire (CAD-Q), to differentiate between COPD and asthma in adults.

METHODS

A cross-sectional study with diagnostic test analysis was done. Relevant clinical variables for diagnosing COPD and asthma were identified through crude Odds Ratios (OR) and a logistic regression model provided adjusted ORs. The CAD-Q, including sensitivity, specificity, predictive values, likelihood ratios, and ROC-curve, was compared to the LFQ, CDQ, PUMA, "Could it be COPD," and COPD-PS questionnaires.

RESULTS

235 (52.9%) patients had COPD and 209 (47.1%) had asthma. A score ≥ 20 on the CAD-Q questionnaire showed a ROC-curve of 70% (95% CI: 65-75; p < 0.001) with a sensitivity of 83.8% (95% CI: 81.1-86.6), specificity of 47.8% (95% CI: 44.1-51.6), positive predictive value of 37.8% (95% CI: 34.2-41.5), negative predictive value of 88.7% (95% CI: 86.3-91), LR + of 1.61 (95% CI: 1.447-1.786), LR - of 0.34 (95% CI: 0.304-0.376) for diagnosing COPD. When comparing CAD-Q with other questionnaires for differentiating COPD and asthma, CAD-Q and CDQ had the highest sensitivity (83.8% and 77.9%). PUMA and "Could it be COPD" had the highest specificity (62.7% and 62.6%). CAD-Q and COPD-PS showed the highest negative predictive values (88.7% and 62.1%). CAD-Q, LFQ, and CDQ had the highest a ROC-curve (70%, 66%, and 66%).

CONCLUSION

The CAD-Q questionnaire effectively discriminated between COPD and asthma, outperforming previous tools. These findings support further research and refinement of diagnostic tools and call for validation in diverse clinical settings.

摘要

背景

慢性阻塞性肺疾病（COPD）和哮喘是两种最常见的慢性呼吸道疾病，对公众健康有重大影响。利用临床问卷来识别和区分COPD和哮喘患者以便进行进一步的诊断程序，已成为解决这一问题的有效策略。我们开发了一种新的诊断工具，即COPD-哮喘鉴别问卷（CAD-Q），用于区分成人COPD和哮喘。

方法

进行了一项带有诊断试验分析的横断面研究。通过粗比值比（OR）确定诊断COPD和哮喘的相关临床变量，并通过逻辑回归模型提供调整后的OR值。将CAD-Q的敏感性、特异性、预测值、似然比和ROC曲线与LFQ、CDQ、PUMA、“是否为COPD”及COPD-PS问卷进行比较。

结果

235名（52.9%）患者患有COPD，209名（47.1%）患有哮喘。CAD-Q问卷得分≥20时，诊断COPD的ROC曲线为70%（95%CI：65 - 75；p < 0.001），敏感性为83.8%（95%CI：81.1 - 86.6），特异性为47.8%（95%CI：44.1 - 51.6），阳性预测值为37.8%（95%CI：34.2 - 41.5），阴性预测值为88.7%（95%CI：86.3 - 9（此处原文有误，应为91）），LR +为1.61（95%CI：1.447 - 1.786），LR -为0.34（95%CI：0.304 - 0.376）。在将CAD-Q与其他区分COPD和哮喘的问卷进行比较时，CAD-Q和CDQ的敏感性最高（分别为83.8%和77.9%）。PUMA和“是否为COPD”的特异性最高（分别为62.7%和62.6%）。CAD-Q和COPD-PS的阴性预测值最高（分别为88.7%和62.1%）。CAD-Q、LFQ和CDQ的ROC曲线最高（分别为70%、66%和66%）。