A new 5-question COPD assessment tool may help identify more serious disease earlier in the primary care setting.
A study reported in the American Journal of Respiratory and Critical Care Medicine offers evidence that 2 screening tools for COPD, when combined, are better than either one alone.
Current screening questionnaires for COPD do not measure disease severity or exacerbation risk and so may be prone to false positive results.
Study included patients aged ≥ 40 years from six primary care centers; patients with ≥ 1 COPD exacerbation in the last year/FEV1 <60% predicted matched with controls with FEV1 ≥ 60% predicted, no exacerbation in the last year).
Combined approach, using CAPTURE and PEF, performed better than either single approach alone, by missing fewer cases and identifying fewer false positives.
Authors note: Sensitivity of CAPTURE scores will permit fewer missed cases of clinically significant COPD, while the higher levels of specificity provided by PEF will result in fewer false positives and lower overall screening costs.
Study limitations: Pulmonary clinics were included in study sites; limited number of patients with mild disease; future studies needed to confirm if early identification improves outcomes.
Take-Home Points: Improved screening will enhance patient selection for treatment; combination of CAPTURE questionnaire and PEF reduced false positives; may improve outcomes, lower costs of care.
Obtaining a peak expiratory flow measurement and asking for a "yes" or "no" answer to 5 questions written at the 6th-grade reading level could help better identify patients with obstructive lung disease seen by primary care physicians who would most benefit from current therapies.
