Abstract：
Rationale: The CAPTURE tool (Chronic Obstructive Pulmonary Disease [COPD] Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk) was developed to identify patients with undiagnosed COPD with an FEV1 <60% predicted or risk of exacerbation as treatment criteria. Objectives: To test the ability of CAPTURE to identify patients requiring treatment because of symptoms or risk of exacerbation or hospitalization. Methods: Data were from COMPASS (Clinical, Radiological and Biological Factors Associated with Disease Progression, Phenotypes and Endotypes of COPD in China), a prospective study of COPD, chronic bronchitis without airflow limitation (postbronchodilator FEV1/FVC ratio ≥0.70), and healthy never-smokers. CAPTURE was tested as questions alone and with peak expiratory flow measurement. Sensitivity, specificity, and positive and negative predicted values (PPV and NPV) were calculated for COPD Assessment Test (CAT) scores ⩾10 versus <10, modified Medical Research Council (mMRC) scores ⩾2 versus <2, and at least one moderate exacerbation or hospitalization in the previous year versus none. Measurements and Main Results: Patients with COPD (n = 1,696) had a mean age of 65 ± 7.5 years, and 90% were male, with a postbronchodilator FEV1 of 66.5 ± 20.1% predicted. Control participants (n = 307) had a mean age of 60.2 ± 7.0 years, and 65% were male, with an FEV1/FVC ratio of 0.78 ± 0.04. CAPTURE using peak expiratory flow showed the best combination of sensitivity and specificity. Sensitivity and specificity were 68.5% and 64.0%, respectively, to detect a CAT score ⩾10; 85.6% and 61.0% to detect an mMRC score ⩾2; 63.5% and 55.6% to detect at least one moderate exacerbation; and 70.2% and 59.4% to detect at least one hospitalization. PPVs ranged from 15.6% (moderate exacerbations) to 47.8% (CAT score). NPVs ranged from 80.8% (CAT score) to 95.6% (mMRC score). Conclusions: CAPTURE has good sensitivity to identify patients with COPD who may require treatment because of increased symptoms or risk of exacerbations or hospitalization, including those with an FEV1 >60% predicted. High NPV values show that CAPTURE can also exclude those who may not require treatment. Clinical trial registered with www.clinicaltrials.gov (NCT04853225).
摘要：
背景：在初级保健中进行COPD评估以识别未诊断的呼吸系统疾病和加重风险（CAPTURE）工具的开发，以识别未诊断的COPD患者，其FEV1预测或加重风险<60％作为治疗标准。
目的：测试CAPTURE识别因症状或恶化或住院风险而需要治疗的患者的能力。
方法：数据来自COMPASS，在中国进行的一项关于COPD的前瞻性研究，无气流受限的慢性支气管炎（支气管扩张剂后FEV1/FVC>0.70），和健康的从不吸烟者。CAPTURE仅作为问题进行测试，并使用峰值呼气流量（PEF）进行测试。灵敏度,特异性，计算CAT≥10vs<10,mMRC≥2vs<2,≥1次中度加重或住院vs前一年无的阳性和阴性预测值(PPV和NPV).
结果：COPD患者（n=1696），平均年龄65±7.5岁，90%的男性,支气管扩张剂后FEV166.5±20.1％pred；对照组（n=307），年龄60.2±7.0岁，65%的男性,FEV1/FVC0.78±0.04。使用PEF的捕获显示出灵敏度和特异性的最佳组合。检测CAT≥10的敏感性和特异性分别为68.5%和64.0%，分别；mMRC≥2(85.6%和61.0%)，≥1中度加重（63.5％和55.6％）和住院（70.2％和59.4％）。PPV范围为15.6%（中度加重）至47.8%（CAT）。净现值在80.8%(CAT)至95.6%(mMRC)之间。
结论：CAPTURE对识别可能因症状升高而需要治疗的COPD患者具有良好的敏感性，恶化或住院的风险，包括那些FEV1>60%的预测。高NPV值表明它也可以排除那些可能不需要治疗的人。
背景：GSK（208630）。
目的：测试CAPTURE识别因症状或恶化或住院风险而需要治疗的患者的能力。
方法：数据来自COMPASS，在中国进行的一项关于COPD的前瞻性研究，无气流受限的慢性支气管炎（支气管扩张剂后FEV1/FVC>0.70），和健康的从不吸烟者。CAPTURE仅作为问题进行测试，并使用峰值呼气流量（PEF）进行测试。灵敏度,特异性，计算CAT≥10vs<10,mMRC≥2vs<2,≥1次中度加重或住院vs前一年无的阳性和阴性预测值(PPV和NPV).
结果：COPD患者（n=1696），平均年龄65±7.5岁，90%的男性,支气管扩张剂后FEV166.5±20.1％pred；对照组（n=307），年龄60.2±7.0岁，65%的男性,FEV1/FVC0.78±0.04。使用PEF的捕获显示出灵敏度和特异性的最佳组合。检测CAT≥10的敏感性和特异性分别为68.5%和64.0%，分别；mMRC≥2(85.6%和61.0%)，≥1中度加重（63.5％和55.6％）和住院（70.2％和59.4％）。PPV范围为15.6%（中度加重）至47.8%（CAT）。净现值在80.8%(CAT)至95.6%(mMRC)之间。
结论：CAPTURE对识别可能因症状升高而需要治疗的COPD患者具有良好的敏感性，恶化或住院的风险，包括那些FEV1>60%的预测。高NPV值表明它也可以排除那些可能不需要治疗的人。
背景：GSK（208630）。
