Löfdahl C G, Postma D S, Laitinen L A, Ohlsson S V, Pauwels R A, Pride N B
Department of Pulmonology, University Hospitals of Lund, Sweden.
Respir Med. 1998 Mar;92(3):467-72. doi: 10.1016/s0954-6111(98)90293-1.
The European Respiratory Society's study on chronic obstructive pulmonary disease (EUROSCOP) is a multicentre study performed initially in 12 countries to assess the effect of 3 years' treatment with inhaled corticosteroids on lung function decline in smokers with chronic obstructive pulmonary disease (COPD). It aimed at recruiting 50 subjects in 50 European centres. This study discusses the most successful, countrywise, recruitment strategies, an important issue since many multicentre European studies may follow in the future. The total number of recruited subjects was 2147 in 39 participating centres. In total, at least 25,000 screening spirometries were performed, and about 80,000 hospital records were checked. The most effective way of recruiting subjects was to screen subjects by spirometry after mass media campaigns (eight out of nine countries). Others used workplace screenings and different types of population survey, and only a few centres successfully recruited participants by hospital records. Inclusion criteria were slightly changed upon low initial accrual rate. Initial surveys in one country, where 2405 subjects were screened by spirometry, gave an important indication for the change of the inclusion criteria. Extension of the upper age limit from 60 to 65 yr considerably improved recruitment, as did a change of the upper limit of FEV1 from below 80% predicted normal to below 100% predicted normal, while maintaining the FEV1/VC ratio below 70%. A tremendous effort is needed to recruit individuals with preclinical COPD, but this is certainly feasible with adequate strategies adjusted to each country.
欧洲呼吸学会慢性阻塞性肺疾病研究（EUROSCOP）是一项多中心研究，最初在12个国家开展，旨在评估吸入性糖皮质激素3年治疗对慢性阻塞性肺疾病（COPD）吸烟者肺功能下降的影响。该研究计划在50个欧洲中心招募50名受试者。本研究讨论了按国家划分的最成功的招募策略，这是一个重要问题，因为未来可能会有许多欧洲多中心研究相继开展。在39个参与中心共招募了2147名受试者。总共至少进行了25000次筛查肺功能测定，并检查了约80000份医院记录。招募受试者最有效的方法是在大众媒体宣传后通过肺功能测定对受试者进行筛查（9个国家中的8个）。其他国家采用工作场所筛查和不同类型的人口调查，只有少数中心通过医院记录成功招募到了参与者。由于初始入组率较低，纳入标准略有变化。在一个国家进行的初步调查中，通过肺功能测定对2405名受试者进行了筛查，这为纳入标准的改变提供了重要指示。将年龄上限从60岁延长至65岁显著改善了招募情况，将第一秒用力呼气容积（FEV1）上限从预测正常值的80%以下改为100%以下，同时保持FEV1/用力肺活量（VC）比值低于70%也起到了同样的效果。招募临床前COPD患者需要付出巨大努力，但通过针对每个国家调整适当的策略，这肯定是可行的。
