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PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study

The early stage of chronic obstructive pulmonary disease (COPD) is not easily recognized. Screening tools can help to identify high-risk patients in primary care settings for spirometry and may be helpful in the early detection in COPD and management. This study aims to validate the PUMA questionnai...

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Autores principales: Au-Doung, Phillip Lung Wai, Wong, Carmen Ka Man, Chan, Dicken Cheong Chun, Chung, Joseph Wai Ho, Wong, Samuel Yeung Shan, Leung, Maria Kwan Wa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462562/
https://www.ncbi.nlm.nih.gov/pubmed/36084011
http://dx.doi.org/10.1371/journal.pone.0274106
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author Au-Doung, Phillip Lung Wai
Wong, Carmen Ka Man
Chan, Dicken Cheong Chun
Chung, Joseph Wai Ho
Wong, Samuel Yeung Shan
Leung, Maria Kwan Wa
author_facet Au-Doung, Phillip Lung Wai
Wong, Carmen Ka Man
Chan, Dicken Cheong Chun
Chung, Joseph Wai Ho
Wong, Samuel Yeung Shan
Leung, Maria Kwan Wa
author_sort Au-Doung, Phillip Lung Wai
collection PubMed
description The early stage of chronic obstructive pulmonary disease (COPD) is not easily recognized. Screening tools can help to identify high-risk patients in primary care settings for spirometry and may be helpful in the early detection in COPD and management. This study aims to validate the PUMA questionnaire for use in Chinese primary care settings. This cross-sectional study recruited participants (≥40 years old, current or former smoker with ≥10 packs of cigarette per year) in primary health care clinics in Hong Kong. The Chinese version of the PUMA questionnaire was administered by trained research staff to participants awaiting consultation. COPD diagnosis was confirmed by spirometry (post-bronchodilator FEV1/FVC <0.70). A total 377 patients were recruited of which 373 completed the spirometry. The percentage of participants diagnosed with COPD (post-bronchodilator FEV1/FVC <0.70) was 27.1%. A higher PUMA score was more likely to have an advanced stage of GOLD classification (P = 0.013). The area under the ROC curve of the PUMA score was 0.753 (95%CI 0.698–0.807). The best cut-point according to Youden’s index for PUMA score was ≥6 with sensitivity 76.5%, specificity 63.3% and negative predictive value (NPV) 63.3%. A cut-off point of PUMA score ≥5 was selected due to higher sensitivity of 91.2%, specificity of 42.6% and high NPV of 92.7%. PUMA score performed better than CDQ and COPD-PS in the area under the ROC curve (0.753 versus 0.658 and 0.612 respectively), had higher sensitivity than COPD-PS (91.2% versus 61%) and had higher specificity than CDQ (42.6% versus 13.1%). The use of PUMA as a screening tool was feasible in Chinese primary care and can be conducted by trained staff and health professionals. The validation results showed high sensitivity and high NPV to identify high risk patient with COPD at cut-off point of ≥5. It can be useful for early detection and management of COPD.
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spelling pubmed-94625622022-09-10 PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study Au-Doung, Phillip Lung Wai Wong, Carmen Ka Man Chan, Dicken Cheong Chun Chung, Joseph Wai Ho Wong, Samuel Yeung Shan Leung, Maria Kwan Wa PLoS One Research Article The early stage of chronic obstructive pulmonary disease (COPD) is not easily recognized. Screening tools can help to identify high-risk patients in primary care settings for spirometry and may be helpful in the early detection in COPD and management. This study aims to validate the PUMA questionnaire for use in Chinese primary care settings. This cross-sectional study recruited participants (≥40 years old, current or former smoker with ≥10 packs of cigarette per year) in primary health care clinics in Hong Kong. The Chinese version of the PUMA questionnaire was administered by trained research staff to participants awaiting consultation. COPD diagnosis was confirmed by spirometry (post-bronchodilator FEV1/FVC <0.70). A total 377 patients were recruited of which 373 completed the spirometry. The percentage of participants diagnosed with COPD (post-bronchodilator FEV1/FVC <0.70) was 27.1%. A higher PUMA score was more likely to have an advanced stage of GOLD classification (P = 0.013). The area under the ROC curve of the PUMA score was 0.753 (95%CI 0.698–0.807). The best cut-point according to Youden’s index for PUMA score was ≥6 with sensitivity 76.5%, specificity 63.3% and negative predictive value (NPV) 63.3%. A cut-off point of PUMA score ≥5 was selected due to higher sensitivity of 91.2%, specificity of 42.6% and high NPV of 92.7%. PUMA score performed better than CDQ and COPD-PS in the area under the ROC curve (0.753 versus 0.658 and 0.612 respectively), had higher sensitivity than COPD-PS (91.2% versus 61%) and had higher specificity than CDQ (42.6% versus 13.1%). The use of PUMA as a screening tool was feasible in Chinese primary care and can be conducted by trained staff and health professionals. The validation results showed high sensitivity and high NPV to identify high risk patient with COPD at cut-off point of ≥5. It can be useful for early detection and management of COPD. Public Library of Science 2022-09-09 /pmc/articles/PMC9462562/ /pubmed/36084011 http://dx.doi.org/10.1371/journal.pone.0274106 Text en © 2022 Au-Doung et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Au-Doung, Phillip Lung Wai
Wong, Carmen Ka Man
Chan, Dicken Cheong Chun
Chung, Joseph Wai Ho
Wong, Samuel Yeung Shan
Leung, Maria Kwan Wa
PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
title PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
title_full PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
title_fullStr PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
title_full_unstemmed PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
title_short PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
title_sort puma screening tool to detect copd in high-risk patients in chinese primary care–a validation study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462562/
https://www.ncbi.nlm.nih.gov/pubmed/36084011
http://dx.doi.org/10.1371/journal.pone.0274106
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