Validity of a questionnaire-based diagnosis of chronic obstructive pulmonary disease in a general population-based study

BMC Pulmonary Medicine

Kjell Torén²  Anna-Carin Olin¹  Giacomo Muzi²  Annika Claesson¹  Jonas Brisman¹  Nicola Murgia² 

[1] Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden;Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy

关键词: GOLD;    ATS/ERS;    Accuracy;    Sensitivity;    Spirometry;    Airway obstruction;   

Others  :  866426
DOI  :  10.1186/1471-2466-14-49

 received in 2013-08-05, accepted in 2014-03-07,  发布年份 2014

【 摘 要 】

Background

The diagnosis of chronic obstructive pulmonary disease (COPD) is based on airflow obstruction. In epidemiological studies, spirometric data have often been lacking and researchers have had to rely almost solely on questionnaire answers. The aim of this study is to assess the diagnostic accuracy of questionnaire answers to detect COPD.

Methods

A sample of the Swedish general population without physician-diagnosed asthma was randomly selected and interviewed using a respiratory questionnaire. All eligible subjects aged 25–75 years (n = 3892) performed spirometry for detection of airflow obstruction using Global Initiative for Chronic Obstructive Lung Disease (GOLD) or American Thoracic Society (ATS)/European Respiratory Society (ERS) criteria. Sensitivity, specificity, positive likelihood ratio (LR+), positive predictive values (PPVs), and negative predictive values (NPVs) were calculated to define diagnostic accuracy of questionnaire answers.

Results

The sensitivity of the question “Have you been diagnosed by a physician as having COPD or emphysema?” in detecting airflow obstruction was 5.7% using GOLD, and 9.8% using ATS/ERS, criteria; specificity was 99.7% for GOLD and 99.5% for ATS/ERS. Sensitivity, specificity, and PPV were higher for the question compared to self-reported symptoms of chronic bronchitis in identifying subjects with airflow obstruction.

Conclusions

The high specificity and good PPV suggest that the question “Have you been diagnosed by a physician as having COPD or emphysema?” is more likely to identify those who do not have airflow obstruction, whereas the low sensitivity of this question could underestimate the real burden of COPD in the general population.

【 授权许可】

   
2014 Murgia et al.; licensee BioMed Central Ltd.

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