Document Detail

Predicting risk of airflow obstruction in primary care: Validation of the lung function questionnaire (LFQ).
MedLine Citation:
PMID:  20226647     Owner:  NLM     Status:  MEDLINE    
The Lung Function Questionnaire (LFQ) is being developed as a case finding tool to identify patients who are appropriate for spirometry testing to confirm the diagnosis of chronic obstructive pulmonary disease (COPD). The cross-sectional study reported herein was conducted to validate the LFQ, to identify item-response scales associated with the best accuracy, and to determine the impact on accuracy of the addition of another item on activity limitations (AL). Patients >or= 40 years old seen at 2 primary care offices completed the LFQ, a demographic questionnaire followed by spirometry. Of the 837 evaluable patients, 18.6% had airflow obstruction (forced expiratory volume in 1 s/forced vital capacity [FEV(1)/FVC] < 0.70). The 5 items (age, wheeze, dyspnea, smoking, and cough) previously identified in initial LFQ development predicted airflow obstruction and showed good evidence of screening accuracy. Screening accuracy was significantly better with 5-point ordinal item-response scales (78%) than binary (yes/no) item-response scales (74%)(p < 0.05). Screening accuracy was good regardless of whether airflow obstruction was defined as FEV(1)/FVC < 0.70 or FEV(1)/FVC < 0.70 and FEV(1) < 80% of predicted. Based on <or=18 was selected to suggest presence of airflow obstruction with area under the receiver operating characteristic curve 0.652; sensitivity 82.6%; specificity 47.8%; 54.3% correctly classified. While the specificity of LFQ is low, its high sensitivity suggests that it can serve to identify patients who should be further assessed using spirometry. Our results confirm the screening accuracy of the LFQ, a simple and effective tool to facilitate early recognition and diagnosis of COPD.
Nicola A Hanania; David M Mannino; Barbara P Yawn; Douglas W Mapel; Fernando J Martinez; James F Donohue; Mark Kosinski; Regina Rendas-Baum; Matthew Mintz; Steven Samuels; Priti Jhingran; Anand A Dalal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2010-03-11
Journal Detail:
Title:  Respiratory medicine     Volume:  104     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2011-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1160-70     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ltd. All rights reserved.
Pulmonary and Critical Care Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA.
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MeSH Terms
Cross-Sectional Studies
Middle Aged
Pulmonary Disease, Chronic Obstructive / diagnosis*,  physiopathology
Questionnaires / standards*
Respiratory Function Tests / methods*
Risk Factors

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