Performance study of a new diagnostic questionnaire for (Chronic obstructive pulmonary -disease) COPD with information on exposure to wood smoke, COPD-WS.

Abstract

Background: To determine the diagnostic performance of a new questionnaire (COPD-WS) that considers also exposure to wood smoke for diagnosing Chronic Obstructive Pulmonary Disease (COPD) in a Colombian population.

Methods: A cross-sectional study was conducted with analysis of diagnostic tests in subjects with and without COPD. Clinical variables were selected based on their relevance to COPD diagnosis, including age, sex, smoking status, exposure to wood smoke, dyspnea, cough, chronic expectoration, and wheezing. A bivariate analysis was performed with the diagnosis of COPD by spirometric criteria. The area under the receiver operating characteristic curve (AUROC) was calculated for the new questionnaire and compared with the LFQ, CDQ, PUMA, COULD IT BE COPD, and COPD-PS questionnaires. The cutoff point for the new questionnaire was obtained through the Youden index, and a p-value <0.05 was considered statistically significant.

Results: A total of 681 patients were included, 187 (27.5%) diagnosed with COPD. The mean age of the population was 65.9 (SD: ±11.79) years, with 53.7% being women and 58.3% having been exposed to wood smoke. The variables included in the questionnaire were age, sex, smoking status, exposure to wood smoke, dyspnea, cough, chronic expectoration, and wheezing. The AUROC for the new COPD-WS questionnaire was 0.69 (95%CI:0.65-0.74;p<0.001), and for a cutoff point ≥6, sensitivity was 0.711 (95%CI:0.677-0.745), specificity was 0.575 (95%CI:0.538-0.612), PPV was 0.388 (95% CI:0.351-0.424), NPV was 0.840 (95%CI:0.813-0.868), LR+ was 1.673 (95%CI:1.458-1.919), LR- was 0.502 (95% CI:0.438-0.576).

Conclusion: This new questionnaire COPD-WS demonstrates acceptable diagnostic capability for diagnosis of COPD in this symptomatic population, and its performance is comparable to other questionnaires currently in use.