Document Detail


Development and Validation of a Screening Tool for Chronic Obstructive Pulmonary Disease in Nursing Home Residents.
MedLine Citation:
PMID:  21450260     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of the study was to develop and validate a simple caregiver-rated questionnaire to screen for chronic obstructive pulmonary disease (COPD) in nursing home residents. DESIGN: Part 1: Identification of screening parameters by the Delphi process using geriatric and pulmonary experts. Part 2: Retrospective analysis of nursing home residents with COPD compared with a gender and age frequency-matched control group of nursing home residents. SETTING: Twelve skilled nursing facilities in Arizona, California, Illinois, Maryland, Missouri, and Ohio. PARTICIPANTS: Nine geriatric and pulmonary experts participated in the identification of screening parameters in Part 1. In Part 2, validation occurred in 64 nursing home residents with COPD and 64 nursing home residents without COPD. INTERVENTION: Retrospective analysis of medical records. MEASUREMENTS: A linear logistic regression routine was used with a stepwise algorithm to identify a "best" set of variables predicting the presence of COPD. The list of variables chosen was then used to define a predictive role for COPD. This role was then characterized by its screening characteristics of sensitivity and specificity. RESULTS: The logistic model identified 4 significant COPD screening parameters: diagnosis of asthma (P = .013), shortness of breath at rest (P = .004) and shortness of breath on exertion (P = .001), and smoking fewer than 19 pack-years (P = .005) or greater than or equal to 19 pack-years (P = .001), with an area-under-the-curve of 0.903. CONCLUSIONS: Nursing home residents with a diagnosis of asthma and have shortness of breath or have been smokers are likely to have COPD.
Authors:
Barbara J Zarowitz; Terrence O'Shea; Allen Lefkovitz; Edward L Peterson
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-8
Journal Detail:
Title:  Journal of the American Medical Directors Association     Volume:  -     ISSN:  1538-9375     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-3-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100893243     Medline TA:  J Am Med Dir Assoc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Wayne State University and Omnicare, Inc., Livonia, MI (B.J.Z.); Professional Services, Omnicare, Inc., c/o Beeber Pharmacy, Englewood, OH (T.O., A.L.); Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, MI (E.L.P.).
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