■慢性阻塞性肺疾病(COPD)在我国发病率较高,但诊断率仍然不足。本研究旨在探索和比较中国基层医疗机构的COPD筛查工具。
■探索COPD筛查工具及其在中国基层医疗机构的联合使用。
■2022年9月至2023年3月，在北京市基层医疗机构对35岁及以上居民进行COPD筛查，中国。筛查涉及使用CAPTURE量表，COPD-SQ量表,和峰值呼气流速测试。这些筛查测试的任何阳性结果都要进行进一步的肺功能测试以确认诊断。灵敏度,特异性，正预测值，负预测值，和受试者工作特征（ROC）曲线计算每个筛选工具单独和组合。
■共有986人完成了筛查测试。CAPTURE量表的阳性率，COPD-SQ量表,和峰值流量计筛选为41.78%，29.11%,和52.03%，分别。在参与者中，166（24.09%）接受了肺功能检查，平均年龄61.69±13.68岁。单独使用时，峰值流量计筛选显示出最高的灵敏度(83.78%)，COPD-SQ量表特异性最好(59.69%),阳性预测值（31.58%），阴性预测值(58.56%)。在三种筛选工具中的任何两种之间观察到显著差异(P<0.05)。在组合中，峰值流量计筛查+COPD-SQ量表显示出最高的准确性，尤登指数为0.277，AUC为0.638。
■单独使用时，现有的COPD筛查工具的准确性存在差异。对于初级医疗机构，最佳的COPD筛查工具是峰值流量计筛查和COPD-SQ问卷的组合.如果受筛选设备条件限制，COPD-SQ问卷可单独用于筛查.
Chronic obstructive pulmonary disease (COPD) has a high incidence rate in
China, but the diagnosis rate remains insufficient. This study aimed to explore and compare COPD screening tools for primary healthcare institutions in
China.
Exploring COPD Screening Tools and Their Combined Use for Primary Healthcare Institutions in
China.
From September 2022 to March 2023, a screening for COPD was conducted among residents aged 35 years and above in primary healthcare institutions in Beijing,
China. The screening involved the use of the CAPTURE scale, COPD-SQ scale, and peak expiratory flow rate test. Any positive results from these screening tests were followed by further pulmonary function testing to confirm the diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) curves were calculated for each screening tool alone and in combination.
A total of 986 individuals completed the screening tests. The positive rates for the CAPTURE scale, COPD-SQ scale, and peak flow meter screening were 41.78%, 29.11%, and 52.03%, respectively. Of the participants, 166 (24.09%) underwent pulmonary function tests, with an average age of 61.69±13.68 years. The peak flow meter screening showed the highest sensitivity (83.78%) when used alone, while the COPD-SQ scale exhibited the best specificity (59.69%), positive predictive value (31.58%), and negative predictive value (58.56%). Significant differences (P<0.05) were observed between any two of the three screening tools. Among the combinations, the peak flow meter screening + COPD-SQ scale showed the highest accuracy, with a Youden index of 0.277 and an AUC of 0.638.
There is variation in the accuracy of existing screening tools for COPD when used alone. For primary healthcare institutions, the optimal COPD screening tool is the combination of peak flow meter screening and the COPD-SQ questionnaire. If limited by screening equipment conditions, the COPD-SQ questionnaire can be used alone for screening.
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