Screening Tool To Help Diagnose COPD

Over 15 million Americans are diagnosed with chronic obstructive pulmonary disease (COPD), a leading cause of death in the United States.  The experts predict millions more have it but do not know it.

Screening Tool To Help Doctors Diagnose More People With COPD
By Pierre Mouchette | Bits-n-Pieces

COPD indicators include coughing, shortness of breath, wheezing or whistling in the chest, and chest tightness or heaviness.  Those with more advanced cases may encounter limitations with regular activities due to an increased risk for lung infections (flu or pneumonia), which can cause COPD flare-ups or exacerbations.  Current treatment options include different types of inhalers, pulmonary rehabilitation, and support for those to quit smoking.

Although researchers are studying ways to improve CAPTURE's accuracy, they emphasize that the screening criteria objective is not to diagnose COPD but to identify patients who would benefit from COPD testing.  The current gold standard for diagnosing the condition is spirometry, a breathing test.
Note:  Doctors tend to underuse spirometry.  Only a third of COPD assessments include it, partly because providers find the tests challenging to integrate into the short primary care office visit.
 
As part of the CAPTURE screening, which some physicians already use, patients answer five questions to evaluate their breathing and exposure to chemicals and air pollution. 

Those with medium scores of 2 to 4 (suggesting moderate breathing issues) receive an in-office breathing test that measures their peak expiratory flow rate (PEFR) or the force of exhalation (lung function).  Adults with PEFR scores of less than 250 L/min for women and less than 350 L/min for men get COPD testing. 

Those with higher questionnaire scores of 5 to 6 skip the PEFR test and automatically get COPD testing. 
An advantage of CAPTURE screening, the researchers said, is that it gives doctors information to assess patients with respiratory symptoms further. 

CAPTURE is designed to be easy for physicians to use.  It is simple, takes less than a minute, and helps identify adults with troubled breathing who need further evaluation.  Based on researchers' analysis, 1 in 81 CAPTURE screenings could identify an adult with treatable but previously undiagnosed COPD.  Researchers are studying if making minor changes, such as changing questions or adding others, can improve the tool's accuracy so that even more patients with COPD can be identified.