Development of a self-scored persistent airflow obstruction screening questionnaire in a general Japanese population: the Hisayama study.
Development of a self-scored persistent airflow obstruction screening questionnaire in a general Japanese population: the Hisayama study.
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DOI：
10.2147/copd.s130453
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发表时间：
2017
影响因子：
2.8
通讯作者：
Inoue H
中科院分区：
文献类型：
--
作者：
Samukawa T;Matsumoto K;Tsukuya G;Koriyama C;Fukuyama S;Uchida A;Mizuno K;Miyahara H;Kiyohara Y;Ninomiya T;Inoue H
使用简单的筛查问卷来检测慢性阻塞性肺病患者的持续性气流阻塞（AO），可能有助于在普通医疗机构中早期准确诊断慢性阻塞性肺病。本研究开发了一种原始的持久性AO问卷，用于在日本普通人群中筛查COPD患者。成立了一个工作组，编制关于慢性阻塞性肺病的初步问卷项目草案。2014年至2015年，要求居住在日本的40岁及以上的符合条件的受试者参加健康检查。在研究1中，2338名受试者完全完成了最初的问卷草案，并进行了有效的肺活量测量，统计分析以确定最终的问卷项目为COPD筛查问卷（COPD- q）。持续性AO定义为支气管扩张剂后FEV1/FVC <0.70。在研究II中，工作组根据Hisayama研究中2066名受试者的数据，分析了各个项目的加权得分，并建立了COPD-Q的分界点。采用受试者工作特征（ROC）曲线检验COPD-Q区分AO患者和非AO患者的能力。五个项目的COPD-Q是根据研究一的19个初稿项目和各个项目的加权得分建立的。COPD-Q的ROC曲线下总面积为0.796（95%可信区间为0.707-0.788）。截断值为4点，敏感性为71.0%，特异性为70.1%。阳性预测值为10.8%，阴性预测值为97.9%。COPD-Q对AO的粗优势比为5.8。五项COPD- q是诊断日本普通人群持续性AO的有用问卷，有望成为检测COPD的有效第一阶段筛查工具。
The use of a simple screening questionnaire to detect persistent airflow obstruction (AO) in COPD may facilitate the early, accurate diagnosis of COPD in general practice settings. This study developed an original persistent AO questionnaire for screening individuals with COPD in a general Japanese population. A working group was established to generate initial draft questionnaire items about COPD. Eligible subjects aged 40 and older living in Japan were solicited to participate in a health checkup from 2014 to 2015. In study I, 2,338 subjects who fully completed the initial draft questionnaire and who had valid spirometry measurements were statistically analyzed to determine the final questionnaire items as a COPD screening questionnaire (COPD-Q). Persistent AO was defined as a post-bronchodilator FEV1/FVC <0.70. In study II, the working group analyzed the weighted scores for individual items and established a cutoff point for the COPD-Q based on the data of 2,066 subjects in the Hisayama study. Receiver operating characteristic (ROC) curves were used to examine the ability of the COPD-Q to discriminate between subjects with and without AO. The five-item COPD-Q was established based on 19 initial draft items in study I and the weighted scores of individual items. The overall area under the ROC curve for the COPD-Q was 0.796 (95% confidence interval, 0.707–0.788). A cutoff of 4 points resulted in a sensitivity of 71.0% and a specificity of 70.1%. The positive predictive value was 10.8%, and the negative predictive value was 97.9%. The crude odds ratio of the COPD-Q for AO was 5.8. The five-item COPD-Q is a useful questionnaire for diagnosing persistent AO in a general Japanese population and is expected to be an effective first-stage screening tool for detecting COPD.