A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease
A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease
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DOI：
10.1164/rccm.201603-0622oc
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发表时间：
2017-03-15
影响因子：
24.7
通讯作者：
Yawn, Barbara P.
中科院分区：
文献类型：
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作者：
Martinez, Fernando J.;Mannino, David;Yawn, Barbara P.
理由：慢性阻塞性肺疾病（COPD）往往未被识别和治疗。目的：开发一种方法来识别需要用现有疗法治疗的未确诊COPD（预测FEV1 = 60%，过去一年无恶化）。在随机森林分析中，我们确定了具有最佳灵敏度（SN）和特异性（SP）的最小问题集和呼气峰流量（PEF）。测量方法及主要结果：186例患者和160例对照者记录肺活量和肺活量。样本人口的平均（SD）年龄为62.7（10.1）岁；55%为女性；86%是白人；16%的人从不吸烟。平均FEY1。预测病例的百分比为42.5% (14.2%)；对照组为82.5%（15.7%）。一份五项问卷，CAPTURE（初级保健中COPD评估以识别未确诊的呼吸疾病和恶化风险），用于评估暴露、呼吸问题、容易疲劳和急性呼吸疾病。CAPTURE在与所有对照组的区分中，SN为95.7%，SP为44.4%；在与非copd对照组的区分中，SN为95.7%，SP为67.8%。PEF(雄性，
Rationale: Chronic obstructive pulmonary disease (COPD) is often unrecognized and untreated.Objectives: To develop a method for identifying undiagnosed COPD requiring treatment with currently available therapies (FEV1 = 60% predicted, no exacerbation in the past year). In random forests analyses, we identified the smallest set of questions plus peak expiratory flow (PEF) with optimal sensitivity (SN) and specificity (SP). Measurements and MainResults: PEF and spirometry were recorded in 186 cases and 160 control subjects. The mean (SD) age of the sample population was 62.7 (10.1) years; 55% were female; 86% were white; and 16% had never smoked. The mean FEY1. percent predicted-for cases was 42.5% (14.2%); for control subjects, it was 82.5% (15.7%). A five-item questionnaire, CAPTURE (COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk), was used to assess exposure, breathing problems, tiring easily, and acute respiratory illnesses. CAPTURE exhibited an SN of 95.7% and an SP of 44.4% for differentiating casesfrom all control subjects, and an SN of 95.7% and an SP of 67.8% for differentiating cases from no-COPD control subjects. The PEF (males,