The Lancet Regional Health: Western Pacific最新文献

{"title":"Neutrality or complacency? Rethinking Singapore’s place in a decolonising global health landscape","authors":"Claire Gabrielle Djuhadi , Kaisin Yee , Hiang Khoon Tan","doi":"10.1016/j.lanwpc.2025.101549","DOIUrl":"10.1016/j.lanwpc.2025.101549","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101549"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Southeast Asia and the Western Pacific ready for potential monkeypox virus outbreaks?","authors":"Janhavi A ,&nbsp;Gregory Gan ,&nbsp;Akira Endo ,&nbsp;Rayner Kay Jin Tan ,&nbsp;Kiesha Prem ,&nbsp;Borame Lee Dickens","doi":"10.1016/j.lanwpc.2025.101526","DOIUrl":"10.1016/j.lanwpc.2025.101526","url":null,"abstract":"<div><div>The new variant of the monkeypox virus (MPXV) clade Ib has recently spread to other African countries outside the Democratic Republic of the Congo (DRC), prompting the World Health Organisation to declare the outbreak as a public health emergency of international concern (PHEIC). This comes just two years after the initial PHEIC that was issued for the clade IIb outbreaks. Compared to the clade IIb outbreaks, clade Ib shows a demographic shift, including higher case fatality rates for younger individuals, indicating a possibility of additional transmission pathways through heterosexual and household contacts. Given that many countries in the Western Pacific (WPR) and the Southeast Asian region (SEAR) hold a disproportionate burden of endemic infectious diseases and have difficulties engaging key at-risk populations, an outbreak of the potentially more virulent clade Ib virus could have devastating impacts on the health care systems. Thus, strategy planning against the potential emergence of clade Ib MPXV in the regions is required, including surveillance systems for detection, modelling studies to perform risk assessments, implementation of non-pharmaceutical interventions, and vaccination, and regional collaboration to ensure equitable distribution of vaccinations.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101526"},"PeriodicalIF":7.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-month prevalence of DSM-5 mental disorders and the psychosocial correlates- a child and adolescent psychiatric epidemiologic survey in Hong Kong SAR","authors":"Sandra S.M. Chan ,&nbsp;Oscar W.H. Wong ,&nbsp;Samara Hussain ,&nbsp;Kelvin K.F. Tsoi ,&nbsp;Karen K.Y. Ma ,&nbsp;Steven W.H. Chau ,&nbsp;Suk Ling Ma ,&nbsp;Kelly Y.C. Lai ,&nbsp;Winnie C.W. Chu ,&nbsp;Holly H.L. Lo ,&nbsp;Stephy W.S. Ho ,&nbsp;Ching Chi Leung ,&nbsp;Karen K.L. Yiu ,&nbsp;Suzanne H.W. So ,&nbsp;Pak C. Sham ,&nbsp;Se Fong Hung ,&nbsp;Patrick W.L. Leung","doi":"10.1016/j.lanwpc.2025.101533","DOIUrl":"10.1016/j.lanwpc.2025.101533","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Childhood and adolescence, as critically important developmental stages, set the premise for the lifelong trajectory of health and well-being. Epidemiologic evidence abounds in purporting that half of all lifetime mental disorders begin in adolescence. Epidemiologic data based on structured clinical diagnostic assessments are disproportionately scarce in Asian countries that host fast-growing youth population along a wide socioeconomic spectrum in the course of globalisation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A cross-sectional school-based epidemiologic survey was conducted on a representative random sample of children and adolescents aged 6–17 years from September 2019 to June 2023 in Hong Kong Special Administrative Region (Hong Kong SAR). The main diagnostic measures were 31 DSM-5 disorders assessed with Diagnostic Interview Schedule for Children, Version 5 (DISC-5) on the whole study sample. One parent/caregiver of each participant was interviewed for cases from primary schools. Separate parent/caregiver and student interviews were conducted for cases from secondary schools where research diagnoses derived from both sources in the adolescent/caregiver pair were combined at disorder level. A host of developmental and psychosocial factors were also collected. The study sample was reconstituted according to the discrepancy between the study population and official population data (census mid-year 2022 and Education Bureau) in terms of age, sex, ethnicity, household income and school type to give weight-adjusted prevalence estimation of various disorders.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The final weighted sample consisted of 6082 participants. The 12-month prevalence of having only one DSM-5 disorder was 13.5% (95% CI: 12.6–14.3%), while the 12-month prevalence of having two or more DSM-5 disorders was 11.0% (95% CI: 10.2–11.8%). The most prevalent disorders/categories of disorders were attention-deficit/hyperactivity disorder (ADHD) (10.2%, 95% CI: 9.4–11.0%); any disruptive, impulse control and conduct disorders (8.8%, CI:8.1–9.5%); any anxiety disorders (6.1%, 95% CI: 5.5–6.7%); any depressive disorders (5.4%, 95% CI: 4.8–6.0%). The 12-month prevalence rates of suicide ideation, plan, and attempt (not including the non-suicidal self-injury) were respectively 3.9% (95% CI: 3.4–4.4%), 1.9% (95% CI: 1.6–2.3%), 1.1% (95% CI: 0.8–1.3%). Parental anxiety and depressive symptoms, any clinically significant sleep disorder, and major school maladjustments (such as repeating a grade, school suspension, absenteeism) were significant factors associated positively (ORs: 1.1–3.37, p-values &lt; 0.01–0.001) with ADHD, externalizing and internalizing disorders in multivariate logistic regressions that account for a multitude of developmental and environmental factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;This study provides the first comprehensive mental health survey on children and adolescents that might inform o","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101533"},"PeriodicalIF":7.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of surgery in Indigenous people with cancer: a systematic review and meta-analysis","authors":"Saira Sanjida ,&nbsp;Gail Garvey ,&nbsp;Roxanne Bainbridge ,&nbsp;Abbey Diaz ,&nbsp;Federica Barzi ,&nbsp;Sherry Holzapfel ,&nbsp;Michael Y. Chen ,&nbsp;Harry Collin ,&nbsp;Yaqoot Fatima ,&nbsp;Xiang-Yu Hou ,&nbsp;James Ward","doi":"10.1016/j.lanwpc.2025.101527","DOIUrl":"10.1016/j.lanwpc.2025.101527","url":null,"abstract":"<div><h3>Background</h3><div>As cancer incidence increases globally, so does the prevalence of cancer among Indigenous peoples. Indigenous peoples face significant barriers to healthcare, including access to and uptake of surgery. To date, the synthesis of access to and uptake of surgery for Indigenous peoples living with cancer has not yet been reported.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review and meta-analysis of access to and uptake of surgery for Indigenous peoples in Canada, Australia, New Zealand, and the United States. Five databases were searched to identify studies of Indigenous adults with cancer and those who received surgery. The Joanna Briggs Institute critical appraisal tools were used to assess the quality and inclusion of articles. Random effect meta-analyses were conducted to estimate the pooled prevalence of surgery in Indigenous people with cancer.</div></div><div><h3>Findings</h3><div>Of the 52 studies in the systematic review, 38 were included in the meta-analysis. The pooled prevalence of surgery in Indigenous people with cancer was 56.2% (95% confidence interval (CI): 45.4–66.7%), including 42.8% (95% CI: 36.3–49.5%) in the Native Hawaiian population, 44.5% (95% CI: 38.7–50.3%) in the Inuit and 51.5% (95%CI: 36.8–65.9%) in Aboriginal and Torres Strait Islander people. Overall, Indigenous people received marginally less cancer surgery than non-Indigenous people (3%, 95% CI: 0–6%). Indigenous people were 15% (95% CI: 6–23%) less likely to receive surgery than non-Indigenous people for respiratory cancers. Remoteness, travel distance, financial barriers, and long waiting times to receive surgery were factors cited as contributing to lower access to surgery for Indigenous people compared to non-Indigenous people.</div></div><div><h3>Interpretation</h3><div>Efforts to improve access and use of cancer services and surgery for Indigenous peoples should be multilevel to address individual factors, health services and systems, and structural barriers. These determinants need to be addressed to expedite optimal care for Indigenous peoples, especially those living in outer metropolitan areas.</div></div><div><h3>Funding</h3><div>The Research Alliance for <span>Urban Goori Health</span> (RAUGH) funded this project. GG was funded by an <span>NHMRC</span> Investigator Grant (<span><span>#1176651</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101527"},"PeriodicalIF":7.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on “when bushfires and the climate crisis become the new normal”","authors":"Supriya Mathew","doi":"10.1016/j.lanwpc.2025.101528","DOIUrl":"10.1016/j.lanwpc.2025.101528","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101528"},"PeriodicalIF":7.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adults","authors":"Paul J. Collings ,&nbsp;Mengyao Wang ,&nbsp;Harrison Hin Sheung Ho ,&nbsp;Shiu Lun Au Yeung ,&nbsp;Parco M. Siu ,&nbsp;Benjamin J. Cowling ,&nbsp;Stephen J. Sharp ,&nbsp;Søren Brage ,&nbsp;Nicholas J. Wareham ,&nbsp;Huaidong Du ,&nbsp;Derrick A. Bennett ,&nbsp;Youngwon Kim ,&nbsp;China Kadoorie Biobank (CKB) Study Collaborative Group","doi":"10.1016/j.lanwpc.2025.101524","DOIUrl":"10.1016/j.lanwpc.2025.101524","url":null,"abstract":"<div><h3>Background</h3><div>In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases.</div></div><div><h3>Methods</h3><div>A prospective cohort study of 462,370 Chinese adults (mean age 51 years; 59% female) who were free from diabetes and cardiovascular diseases at baseline. Isotemporal substitution Cox regression models were used to estimate the associations of reallocating self-reported sedentary leisure-time to the same amount of sleep, housework, Taichi, or conventional exercise (e.g., walking, jogging, ball games, swimming) with the risk of incident diabetes, stroke, and myocardial infarction (MI). The results are reported as adjusted hazard ratios and 95% confidence intervals per 30 min/day time exchanges. Potential impact fractions were calculated to estimate the proportional reductions in incident disease cases associated with time substitutions, assuming causality.</div></div><div><h3>Findings</h3><div>During &gt;5.25 million person-years of follow-up, 19,738 incident diabetes, 51,460 stroke, and 6767 MI cases were accrued. Lower disease risks were found for replacement of sedentary leisure-time by sleep (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.97 [0.94–0.99]; in participants who slept &lt;7 h/day), housework (diabetes: 0.97 [0.97–0.98], stroke: 0.99 [0.98–0.99], MI: 0.97 [0.95–0.98]), Taichi (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.95 [0.92–0.98]), or conventional exercise (diabetes: 0.97 [0.95–0.99], stroke: 0.97 [0.95–0.98], MI: 0.92 [0.88–0.96]). Potential impact fractions ranged from an estimated 3.5% (95% confidence interval: 3.1–3.9%) fewer cases of incident stroke when replacing sedentary leisure-time with housework, to an estimated 9.6% (5.9–13.3%) fewer cases of incident MI when reallocating sedentary leisure-time to conventional exercise.</div></div><div><h3>Interpretation</h3><div>Replacing sedentary leisure-time with behaviours such as housework, Taichi, sleep (in short sleepers) and conventional exercise is associated with lower risks of common cardiometabolic diseases in Chinese adults. Prevention strategies should be developed to promote movement behaviours and optimal levels of sleep at the expense of sedentary leisure-time.</div></div><div><h3>Funding</h3><div>This analysis was supported by a <span>Health and Medical Research Fund</span> (HMRF) Research Fellowship (grant no: <span><span>06200087</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101524"},"PeriodicalIF":7.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent lymphatic filariasis transmission seven years after validation of elimination as a public health problem: a cross-sectional study in Tonga","authors":"Harriet L.S. Lawford ,&nbsp;‘Ofa Tukia ,&nbsp;Joseph Takai ,&nbsp;Sarah Sheridan ,&nbsp;Selina Ward ,&nbsp;Holly Jian ,&nbsp;Beatris Mario Martin ,&nbsp;Reynold ‘Ofanoa ,&nbsp;Colleen L. Lau","doi":"10.1016/j.lanwpc.2025.101513","DOIUrl":"10.1016/j.lanwpc.2025.101513","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) has validated 21 countries as having eliminated lymphatic filariasis (LF) as a public health problem. Post-validation surveillance (PVS) is required in countries where LF has been eliminated. Tonga eliminated LF in 2017, but no PVS strategy has been established. We aimed to identify any persistent LF transmission in Tonga in 2024 and provide evidence to support a PVS strategy.</div></div><div><h3>Methods</h3><div>A four-pronged, targeted, cross-sectional study was conducted in the Tongan districts of Tongatapu, Ha’apai, and Ongo Niuas in May–July 2024 in communities, primary schools, high schools, and an outpatient clinic. Participants were tested for LF antigen (Ag) and microfilariae (Mf). The outcome measure for persistent LF transmission was Ag-positivity.</div></div><div><h3>Findings</h3><div>Between 9 May and 19 July 2024, 1787 participants were recruited from 12 communities, 11 primary schools, five high schools, and one outpatient clinic. Overall, 39 participants (2·2%) were Ag-positive and five (0·3%) were Mf-positive. The highest Ag prevalence was in communities (4·0%; 95% confidence interval [95%CI]: 2·9–5·6), where all Mf-positives (n = 5) were identified. Ag-positivity was associated with male sex (adjusted odds ratio [aOR]:4·86; 95%CI: 2·25–10·46), older age (&gt;50 years vs 5–10 years [aOR:7·51; 95%CI: 2·13–26·47]), and residing in Ha’apai (aOR:15·08; 95%CI: 5·41–42·05) and Ongo Niuas (aOR:10·85; 95%CI: 3·91–30·08).</div></div><div><h3>Interpretation</h3><div>We found persistent LF transmission in Tonga seven years post-validation. Community surveillance yielded the highest Ag and Mf prevalence. Efficiency of PVS could be improved by integrating surveillance activities into the existing health system and conducting community-based surveys, particularly among older males and in high prevalence areas.</div></div><div><h3>Funding</h3><div><span>Task Force for Global Health</span>, <span>Bill &amp; Melinda Gates Foundation</span>, and the <span>United States Agency for International Development</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101513"},"PeriodicalIF":7.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care provided to women during and after a pregnancy complicated by hyperglycaemia: the impacts of a multi-component health systems intervention","authors":"Diana MacKay ,&nbsp;Jacqueline A. Boyle ,&nbsp;Sandra Campbell ,&nbsp;Natasha Freeman ,&nbsp;Anna McLean ,&nbsp;Denella Hampton ,&nbsp;Cherie Whitbread ,&nbsp;Paula Van Dokkum ,&nbsp;Kirby Murtha ,&nbsp;Christine Connors ,&nbsp;Elizabeth Moore ,&nbsp;Ashim Sinha ,&nbsp;Yvonne Cadet-James ,&nbsp;Sharni Cardona ,&nbsp;Jeremy Oats ,&nbsp;H David McIntyre ,&nbsp;Anthony J. Hanley ,&nbsp;Alex Brown ,&nbsp;Jonathan E. Shaw ,&nbsp;Renae Kirkham ,&nbsp;Louise Maple-Brown","doi":"10.1016/j.lanwpc.2025.101514","DOIUrl":"10.1016/j.lanwpc.2025.101514","url":null,"abstract":"<div><h3>Background</h3><div>Aboriginal and Torres Strait Islander women experience a disproportionate burden of hyperglycaemia in pregnancy. A multi-component health systems intervention aiming to improve antenatal and postpartum care was implemented across Australia’s Northern Territory (NT) and Far North Queensland (FNQ) between 2016 and 2019. Components included clinician education, improving recall systems, enhancing policies and guidelines, and embedding Diabetes in Pregnancy (DIP) Clinical Registers in systems of care. This program was evaluated to determine impacts on clinical practice and maternal health.</div></div><div><h3>Methods</h3><div>Data for women with hyperglycaemia in pregnancy from primary care clinical records and the DIP Clinical Registers were analysed to assess changes in: antenatal and postpartum diabetes testing; HbA1c/glucose levels; medication use; weight checks performed, weight and body mass index; and postpartum contraception, smoking and breastfeeding.</div></div><div><h3>Findings</h3><div>Clinical practice in the NT improved, including increased uptake of the recommended first trimester 75 g oral glucose tolerance test among women with hyperglycaemia risk factors (Aboriginal and Torres Strait Islander women 11.7% to 26.5%, p &lt; 0.001; non-Indigenous women 6.2% to 19.3%, p &lt; 0.001). In the NT, postpartum diabetes monitoring (56% to 68%, p = 0.039) and contraceptive use (41% to 60%, p = 0.001) increased among Aboriginal and Torres Strait Islander women. In FNQ, postpartum glucose monitoring increased among women with T2D (26% to 68% Aboriginal and Torres Strait Islander, p = 0.002; 50% to 100% non-Indigenous, p = 0.008), although there were no improvements in antenatal care indicators.</div></div><div><h3>Interpretation</h3><div>Aspects of care for women with hyperglycaemia in pregnancy improved in the NT and FNQ following a multi-component health systems intervention.</div></div><div><h3>Funding</h3><div>This study is funded by the <span>Australian National Health and Medical Research Council</span> (NHMRC) <span>Global Alliance for Chronic Diseases</span> Grant <span><span>1092968</span></span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101514"},"PeriodicalIF":7.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulse oscillometry-derived equation for prediction of abnormal FEV1/FVC ratio for COPD screening in Chinese population: a multicenter cross-sectional study","authors":"Meishan Liu ,&nbsp;Xin Yao ,&nbsp;Yiwei Shi ,&nbsp;Huiguo Liu ,&nbsp;Liang Chen ,&nbsp;Yong Lu ,&nbsp;Chunmei Zhang ,&nbsp;Xinran Zhang ,&nbsp;Lirong Liang ,&nbsp;Xiaohong Chang ,&nbsp;Li An ,&nbsp;Kian Fan Chung ,&nbsp;Janwillem W.H. Kocks ,&nbsp;Kewu Huang","doi":"10.1016/j.lanwpc.2025.101501","DOIUrl":"10.1016/j.lanwpc.2025.101501","url":null,"abstract":"<div><h3>Background</h3><div>The diagnosis of chronic obstructive pulmonary disease (COPD) is based on spirometry that requires a forced expiratory manoeuvre, which is laborious and difficult for mass screening. Impulse oscillometry (IOS) is easier than spirometry and performed with tidal breathing. We sought to develop an equation for predicting forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) and screening COPD using IOS parameters.</div></div><div><h3>Methods</h3><div>Data from patients who simultaneously underwent spirometry and IOS were obtained from databases at five tertiary hospitals in China. Multivariable linear regression analysis was used to develop a predictive model for pre-bronchodilator (BD) FEV₁/FVC. Model performance was analyzed against spirometric criteria of airflow obstruction (AO, defined as pre-BD FEV₁/FVC &lt; 0.7) and COPD (post-BD FEV₁/FVC &lt; 0.7).</div></div><div><h3>Findings</h3><div>Using 15,113 patients and externally validated with 9586 patients, the model estimated FEV₁/FVC ratio could identified AO and spirometry-defined COPD in internal (AUC = 0.822 and 0.849, respectively) and external (AUC = 0.790 and 0.828, respectively) validation. A clinical algorithm was constructed to classify patients into three different groups: estimated FEV₁/FVC &lt; 0.7: likely COPD; estimated FEV₁/FVC ≥ 0.7 and ≤0.73: suspicious for COPD; estimated FEV₁/FVC &gt; 0.73: unlikely COPD. The sensitivity and specificity for detecting spirometry-defined COPD were 88.0% and 77.0%, respectively, while the negative predictive value ranged from 93.7% to 98.6% and positive predictive value ranged from 26.5% to 62.1% across different COPD prevalence groups in the Chinese population.</div></div><div><h3>Interpretation</h3><div>This equation could be useful to screen for COPD particularly in community and primary care settings.</div></div><div><h3>Funding</h3><div>The Financial Budgeting Project of <span>Beijing Institute of Respiratory Medicine</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101501"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers to primary care research in Japan: a call to action","authors":"Thomas Rouyard ,&nbsp;Emilie Yoda ,&nbsp;Ryota Nakamura ,&nbsp;Michiko Moriyama ,&nbsp;Masako Ii ,&nbsp;Maham Stanyon ,&nbsp;Mei Endo ,&nbsp;Koki Nakamura ,&nbsp;Satoshi Kanke ,&nbsp;Ryuki Kassai","doi":"10.1016/j.lanwpc.2025.101523","DOIUrl":"10.1016/j.lanwpc.2025.101523","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101523"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}