Assessment of Five Different Guideline Indication Criteria for Spirometry, Including Modified GOLD Criteria, in Order to Detect COPD: Data from 5,315 Subjects in the PLATINO Study

Overview

Journal NPJ Prim Care Respir Med

Specialties Public Health
Pulmonary Medicine

Date 2014 Oct 31

PMID 25358021

Citations 6

Authors

Ana P Luize

Ana Maria B Menezes

Rogelio Perez-Padilla

Adriana Muino

Maria Victorina Lopez

Gonzalo Valdivia

Carmem Lisboa

Maria Montes de Oca

Carlos Talamo

Bartolome Celli

Oliver A Nascimento

Mariana R Gazzotti

Jose R Jardim

Affiliations

Soon will be listed here.

Abstract

Background: Spirometry is the gold standard for diagnosing chronic obstructive pulmonary disease (COPD). Although there are a number of different guideline criteria for deciding who should be selected for spirometric screening, to date it is not known which criteria are the best based on sensitivity and specificity.

Aims: Firstly, to evaluate the proportion of subjects in the PLATINO Study that would be recommended for spirometry testing according to Global initiative for Obstructive Lung Disease (GOLD)-modified, American College of Chest Physicians (ACCP), National Lung Health Education Program (NLHEP), GOLD and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria. Secondly, we aimed to compare the sensitivity, specificity, and positive predictive and negative predictive values, of these five different criteria.

Methods: Data from the PLATINO study included information on respiratory symptoms, smoking and previous spirometry testing. The GOLD-modified spirometry indication criteria are based on three positive answers out of five questions: the presence of cough, phlegm in the morning, dyspnoea, age over 40 years and smoking status.

Results: Data from 5,315 subjects were reviewed. Fewer people had an indication for spirometry (41.3%) according to the GOLD-modified criteria, and more people had an indication for spirometry (80.4%) by the GOLD and ATS/ERS criteria. A low percentage had previously had spirometry performed: GOLD-modified (14.5%); ACCP (13.2%); NLHEP (12.6%); and GOLD and ATS/ERS (12.3%). The GOLD-modified criteria showed the least sensitivity (54.9) and the highest specificity (61.0) for detecting COPD, whereas GOLD and ATS/ERS criteria showed the highest sensitivity (87.9) and the least specificity (20.8).

Conclusion: There is a considerable difference in the indication for spirometry according to the five different guideline criteria. The GOLD-modified criteria recruit less people with the greatest sum of sensitivity and specificity.

Citing Articles

Using flexible methods to determine risk factors for ventilator-associated pneumonia in the Netherlands.

van der Kooi T, Boshuizen H, Wille J, De Greeff S, van Dissel J, Schoffelen A PLoS One. 2019; 14(6):e0218372.

PMID: 31220122 PMC: 6586305. DOI: 10.1371/journal.pone.0218372.

Chronic Obstructive Pulmonary Disease in Latin America.

Perez-Padilla R, Menezes A Ann Glob Health. 2019; 85(1).

PMID: 30741508 PMC: 7052319. DOI: 10.5334/aogh.2418.

Spirometry in Asthma Care: A Review of the Trends and Challenges in Pediatric Practice.

Ayuk A, Uwaezuoke S, Ndukwu C, Ndu I, Iloh K, Okoli C Clin Med Insights Pediatr. 2017; 11:1179556517720675.

PMID: 28781518 PMC: 5521334. DOI: 10.1177/1179556517720675.

Respiratory illness and air pollution from the steel industry: the case of Piquiá de Baixo, Brazil (Preliminary report).

Valenti C, Pozzi P, Busia A, Mazza R, Bossi P, De Marco C Multidiscip Respir Med. 2016; 11:41.

PMID: 27833748 PMC: 5101733. DOI: 10.1186/s40248-016-0077-9.

Correlation of the Ratio of Upper Third to Lower Third Circumferences of the Chest with Obstructive Pattern in Spirometry.

Alavi Foumani A, Amin A, Tangestani Nejad A, Kazemnejad E, Salamat F, Massahnia S Tanaffos. 2016; 14(4):222-6.

PMID: 27114722 PMC: 4841987.

References

Enright P, Crapo R . Controversies in the use of spirometry for early recognition and diagnosis of chronic obstructive pulmonary disease in cigarette smokers. Clin Chest Med. 2001; 21(4):645-52. DOI: 10.1016/s0272-5231(05)70174-x. View

. Strategies in preserving lung health and preventing COPD and associated diseases. The National Lung Health Education Program (NLHEP). Chest. 1998; 113(2 Suppl):123S-163S. DOI: 10.1378/chest.113.2_supplement.123s. View

Qaseem A, Snow V, Shekelle P, Sherif K, Wilt T, Weinberger S . Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2007; 147(9):633-8. View

Soriano J, Miravitlles M, Garcia-Rio F, Munoz L, Sanchez G, Sobradillo V . Spirometrically-defined restrictive ventilatory defect: population variability and individual determinants. Prim Care Respir J. 2012; 21(2):187-93. PMC: 6547920. DOI: 10.4104/pcrj.2012.00027. View

Celli B, MacNee W . Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004; 23(6):932-46. DOI: 10.1183/09031936.04.00014304. View

Caramori G, Bettoncelli G, Tosatto R, Arpinelli F, Visona G, Invernizzi G . Underuse of spirometry by general practitioners for the diagnosis of COPD in Italy. Monaldi Arch Chest Dis. 2005; 63(1):6-12. DOI: 10.4081/monaldi.2005.651. View

Joo M, Au D, Fitzgibbon M, McKell J, Lee T . Determinants of spirometry use and accuracy of COPD diagnosis in primary care. J Gen Intern Med. 2011; 26(11):1272-7. PMC: 3208468. DOI: 10.1007/s11606-011-1770-1. View

Hill K, Goldstein R, Guyatt G, Blouin M, Tan W, Davis L . Prevalence and underdiagnosis of chronic obstructive pulmonary disease among patients at risk in primary care. CMAJ. 2010; 182(7):673-8. PMC: 2855915. DOI: 10.1503/cmaj.091784. View

Morice A, Kastelik J . Cough. 1: Chronic cough in adults. Thorax. 2003; 58(10):901-7. PMC: 1746472. DOI: 10.1136/thorax.58.10.901. View

10.

Wahls S . Causes and evaluation of chronic dyspnea. Am Fam Physician. 2012; 86(2):173-82. View

11.

Medbo A, Melbye H . What role may symptoms play in the diagnosis of airflow limitation? A study in an elderly population. Scand J Prim Health Care. 2008; 26(2):92-8. PMC: 3406655. DOI: 10.1080/02813430802028938. View

12.

Soriano J, Zielinski J, Price D . Screening for and early detection of chronic obstructive pulmonary disease. Lancet. 2009; 374(9691):721-32. DOI: 10.1016/S0140-6736(09)61290-3. View

13.

Hardie J, Buist A, Vollmer W, Ellingsen I, Bakke P, Morkve O . Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers. Eur Respir J. 2002; 20(5):1117-22. DOI: 10.1183/09031936.02.00023202. View

14.

. The European Community Respiratory Health Survey II. Eur Respir J. 2002; 20(5):1071-9. DOI: 10.1183/09031936.02.00046802. View

15.

Bourbeau J, van der Palen J . Promoting effective self-management programmes to improve COPD. Eur Respir J. 2009; 33(3):461-3. DOI: 10.1183/09031936.00001309. View

16.

Buffels J, Degryse J, Heyrman J, Decramer M . Office spirometry significantly improves early detection of COPD in general practice: the DIDASCO Study. Chest. 2004; 125(4):1394-9. DOI: 10.1378/chest.125.4.1394. View

17.

Wilt T, Niewoehner D, Kim C, Kane R, Linabery A, Tacklind J . Use of spirometry for case finding, diagnosis, and management of chronic obstructive pulmonary disease (COPD). Evid Rep Technol Assess (Summ). 2005; (121):1-7. PMC: 4781180. DOI: 10.1037/e439492005-001. View

18.

Dales R, Vandemheen K, Clinch J, Aaron S . Spirometry in the primary care setting: influence on clinical diagnosis and management of airflow obstruction. Chest. 2005; 128(4):2443-7. DOI: 10.1378/chest.128.4.2443. View

19.

King P, Holdsworth S, Farmer M, Freezer N, Villanueva E, Holmes P . Phenotypes of adult bronchiectasis: onset of productive cough in childhood and adulthood. COPD. 2009; 6(2):130-6. DOI: 10.1080/15412550902766934. View

20.

Natt R, Earis J, Swift A . Chronic cough: a multidisciplinary approach. J Laryngol Otol. 2012; 126(5):441-4. DOI: 10.1017/S0022215111003409. View