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Screening for COPD in Primary Care

The CAPTURE tool was ineffective in identifying undiagnosed, clinically important COPD in the primary care setting, researchers report. The tool “had a low sensitivity but a high specificity for identifying clinically significant COPD defined by presence of airflow obstruction that is of moderate severity or accompanied by a history of acute respiratory illness,” conclude the authors. “Further research is needed to optimize performance of the screening tool and to understand whether its use affects clinical outcomes.”

The cross-sectional study included 4,679 primary care patients 45–80 years of age without a prior COPD diagnosis. Based on a primary outcome of the CAPTURE tool’s sensitivity and specificity for identifying patients with undiagnosed, clinically significant COPD, the results showed: “Of the 4,325 patients who had adequate data for analysis (63.0% were women; the mean age was 61.6 years [SD, 9.1 years]), 44.6% had ever smoked cigarettes, 18.3% reported a prior asthma diagnosis or use of inhaled respiratory medications, 13.2% currently smoked cigarettes, and 10.0% reported at least 1 cardiovascular comorbidity. Among the 110 patients (2.5% of 4325) with undiagnosed, clinically significant COPD, 53 had a positive screening result with a sensitivity of 48.2% (95% CI, 38.6%-57.9%) and a specificity of 88.6% (95% CI, 87.6%-89.6%). The area under the receiver operating curve for varying positive screening thresholds was 0.81 (95% CI, 0.77-0.85).”

Source: JAMA