Comparative Study on Chronic Obstructive Pulmonary Disease Screening Tools in Primary Healthcare Institutions in Beijing, China

Abstract

Xu Yang,1 Mi Yao,2 Delu Yin,3 Na Zhang,1 Jing Li,1 Yan Jiang,1 Rundong Fu,1 Yi Qian1 1Department of General Practice, Donghuashi Community Health Service Center, Beijing, People’s Republic of China; 2Department of General Practice, Peking University Health Science Center, Beijing, People’s Republic of China; 3Department of Health Development, Capital Institute of Pediatrics, Beijing, People’s Republic of ChinaCorrespondence: Xu Yang, Department of General Practice, Donghuashi Community Health Service Center, 33 Donghuashi Street, Dongcheng District, Beijing, 100062, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected]: Chronic obstructive pulmonary disease (COPD) has a high incidence rate in China, but the diagnosis rate remains insufficient. This study aimed to explore and compare COPD screening tools for primary healthcare institutions in China.Purpose: Exploring COPD Screening Tools and Their Combined Use for Primary Healthcare Institutions in China.Patients and Methods: From September 2022 to March 2023, a screening for COPD was conducted among residents aged 35 years and above in primary healthcare institutions in Beijing, China. The screening involved the use of the CAPTURE scale, COPD-SQ scale, and peak expiratory flow rate test. Any positive results from these screening tests were followed by further pulmonary function testing to confirm the diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) curves were calculated for each screening tool alone and in combination.Results: A total of 986 individuals completed the screening tests. The positive rates for the CAPTURE scale, COPD-SQ scale, and peak flow meter screening were 41.78%, 29.11%, and 52.03%, respectively. Of the participants, 166 (24.09%) underwent pulmonary function tests, with an average age of 61.69± 13.68 years. The peak flow meter screening showed the highest sensitivity (83.78%) when used alone, while the COPD-SQ scale exhibited the best specificity (59.69%), positive predictive value (31.58%), and negative predictive value (58.56%). Significant differences (P< 0.05) were observed between any two of the three screening tools. Among the combinations, the peak flow meter screening + COPD-SQ scale showed the highest accuracy, with a Youden index of 0.277 and an AUC of 0.638.Conclusion: There is variation in the accuracy of existing screening tools for COPD when used alone. For primary healthcare institutions, the optimal COPD screening tool is the combination of peak flow meter screening and the COPD-SQ questionnaire. If limited by screening equipment conditions, the COPD-SQ questionnaire can be used alone for screening.Keywords: primary health care institutions, chronic obstructive pulmonary disease, COPD, screening questionnaire, peak flow rate test, pulmonary function tests

Keywords

• primary health care institutions
• chronic obstructive pulmonary disease
• copd
• screening questionnaire
• peak flow rate test；pulmonary function tests.