Screening accuracy for four common questionnaires of chronic obstructive pulmonary disease: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Xiuxiu ¹ , LIU Yue ² , ZHANG Ran ² ,  CAI Weixin ¹

1. Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, P. R. China;
2. Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, P. R. China;

Corresponding author：

CAI Weixin, Email: caiwx9@163.com

Keywords：

Chronic obstructive pulmonary disease; Sensitivity; Specificity; Network meta-analysis; Evidence-based nursing

DOI：

10.7507/1672-2531.202207149

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the diagnostic value of common screening questionnaires for chronic obstructive pulmonary disease (COPD). Methods The Cochrane Library, Web of Science, PubMed, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect diagnostic studies on the effectiveness of COPD screening questionnaires from inception to January 31 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies,then network meta-analysis was performed by using Meta-disc 1.4 and Stata 15.0 software. Results A total of 28 studies involving 4 screening questionnaires were included. The results of the network meta-analysis showed that, sensitivity sorting was CDQ₁₇ > LFQ > COPD-PS₄ > CDQ₂₀ > COPD-SQ > COPD-PS₅, the specificity sorting was COPD-SQ > COPD-PS₅ > CDQ₂₀ > CDQ₁₇ > COPD-PS₄ > LFQ. Subgroup analysis showed the sensitivity of CDQ₁₇ and specificity of CDQ₂₀ were the highest in China, the sensitivity of LFQ and specificity of COPD-PS₅ were the highest in foreign countries. Conclusion Current evidence suggests that CDQ and LFQ have high sensitivity but poor specificity, while COPD-SQ and COPD-PS have strong specificity but poor sensitivity. In China, CDQ is recommended for screening of COPD patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： WANG Xiuxiu, LIU Yue, ZHANG Ran, CAI Weixin. Screening accuracy for four common questionnaires of chronic obstructive pulmonary disease: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(2): 179-185. doi: 10.7507/1672-2531.202207149 Copy

1.	Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
2.	王秀秀. 饮食及体力活动因素与老年慢性阻塞性肺疾病关系的病例-对照研究. 石家庄: 河北医科大学, 2021.
3.	包鹤龄, 方利文, 王临虹. 1990-2014年中国40岁及以上人群慢性阻塞性肺疾病患病率Meta分析. 中华流行病学杂志, 2016, 37(1): 119-124.
4.	韩丁. 三种问卷在慢性阻塞性肺疾病中的筛查价值. 昆明: 昆明医科大学, 2020.
5.	赵海金, 赵文驱, 彭显如. 重视慢性阻塞性肺疾病的早期诊断和早期干预. 实用医学杂志, 2018, 34(21): 3493-3495.
6.	王明航, 毕丽婵, 赵欢欢, 等. 慢性阻塞性肺疾病早期筛查技术应用研究进展. 中国老年学杂志, 2022, 42(10): 2529-2532.
7.	柳月, 袁媛. 慢性阻塞性肺疾病筛查工具准确性的网状Meta分析. 中国全科医学, 2022, 25(35): 4443-4452.
8.	2022 GOLD Reports. Global initiative for chronic obstructive lung disease, 2022/7/14. Available at:https://goldcopd.org/2022-gold-reports-2/.
9.	曹慧慧. 超声、X线、CT对诊断血胸价值的Meta分析及超声对血胸定量诊断研究. 兰州: 甘肃中医药大学, 2018.
10.	王玲, 王梦书, 周奇. 超声诊断尺桡骨远端骨折价值的系统评价. 中国循证医学杂志, 2017, 17(2): 213-220.
11.	张天嵩, 钟文昭. Meta-DiSc软件在诊断试验Meta分析中的应用. 循证医学, 2008, 8(2): 97-100,108.
12.	Frith P, Crockett A, Beilby J, et al. Simplified COPD screening: validation of the PiKo-6® in primary care. Prim Care Respir J, 2011, 20(2): 190-198.
13.	Jarhyan P, Hutchinson A, Khatkar R, et al. Diagnostic accuracy of a two-stage sequential screening strategy implemented by community health workers (CHWs) to identify individuals with COPD in rural India. Int J Chron Obstruct Pulmon Dis, 2021, 16: 1183-1192.
14.	Kotz D, Nelemans P, van Schayck CP, et al. External validation of a COPD diagnostic questionnaire. Eur Respir J, 2008, 31(2): 298-303.
15.	Llordés M, Zurdo E, Jaén Á, et al. Which is the Best Screening Strategy for COPD among Smokers in Primary Care. COPD, 2017, 14(1): 43-51.
16.	Martinez FJ, Raczek AE, Seifer FD, et al. Development and initial validation of a self-scored COPD Population Screener Questionnaire (COPD-PS). COPD, 2008, 5(2): 85-95.
17.	Mintz ML, Yawn BP, Mannino DM, et al. Prevalence of airway obstruction assessed by lung function questionnaire. Mayo Clin Proc, 2011, 86(5): 375-381.
18.	Price DB, Tinkelman DG, Nordyke RJ, et al. Scoring system and clinical application of COPD diagnostic questionnaires. Chest, 2006, 129(6): 1531-1539.
19.	Ronaldson SJ, Dyson L, Clark L, et al. Determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease: The DOC study. J Eval Clin Pract, 2018, 24(3): 487-495.
20.	Sichletidis L, Spyratos D, Papaioannou M, et al. A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting. Prim Care Respir J, 2011, 20(2): 184-189.
21.	Soriano JB, Molina J, Miravitlles M. Combining case-finding methods for COPD in primary care: a large, two-stage design study. Int J Tuberc Lung Dis, 2018, 22(1): 106-111.
22.	Spyratos D, Haidich AB, Chloros D, et al. Comparison of three screening questionnaires for chronic obstructive pulmonary disease in the primary care. Respiration, 2017, 93(2): 83-89.
23.	Stanley AJ, Hasan I, Crockett AJ, et al. COPD Diagnostic Questionnaire (CDQ) for selecting at-risk patients for spirometry: a cross-sectional study in Australian general practice. NPJ Prim Care Respir Med, 2014, 24: 14024.
24.	Tsukuya G, Samukawa T, Matsumoto K, et al. Comparison of the COPD population screener and international primary care airway group questionnaires in a general Japanese population: the Hisayama study. Int J Chron Obstruct Pulmon Dis, 2016, 11: 1903-1909.
25.	Tsukuya G, Matsumoto K, Fukuyama S, et al. Validation of a COPD screening questionnaire and establishment of diagnostic cut-points in a Japanese general population: the Hisayama study. Allergol Int, 2015, 64(1): 49-53.
26.	陈淑云. 慢性阻塞性肺病社区综合防治适宜技术的初步研究. 广州: 广州医科大学, 2014.
27.	杜明明, 董礼, 吕俊. 两种方法筛查宜宾市60岁以上居民慢性阻塞性肺疾病的一致性研究. 实用老年医学, 2021, 35(2): 141-144.
28.	葛妍麟, 陈红, 杨嫦娟. 基于症状的慢性阻塞性肺疾病筛查问卷在社区人群中的应用. 当代护士(下旬刊), 2014, (11): 124-125.
29.	吉珉. 筛查问卷与肺功能检查在宁海山区老年人慢阻肺诊断中的应用价值分析. 医药前沿, 2019, 9(20): 254.
30.	李云海, 李俊, 张楠, 等. 慢阻肺筛查问卷加肺功能检查对慢阻肺的早期诊断作用研究. 世界最新医学信息文摘, 2019, 19(61): 246-247.
31.	刘妍, 邓笑伟. 筛查问卷与肺功能检查在慢性阻塞性肺疾病早期诊断中的研究. 临床肺科杂志, 2015, 20(3): 500-503.
32.	石喆, 王石林, 汪海燕, 等. 适宜国人BMI分级的慢性阻塞性肺疾病筛查问卷的检验与评价. 中华全科医师杂志, 2014, 13(3): 184-187.
33.	陶学芳, 邵银燕, 孙金军, 等. 基于症状的慢性阻塞性肺疾病筛查问卷诊断效果评价. 预防医学, 2019, 31(7): 693-695.
34.	王娟, 许文兵, 曾学军, 等. 中文版慢性阻塞性肺疾病筛查问卷在吸烟者中的初步检验与评价. 中华内科杂志, 2012, 51(4): 311-312.
35.	王石林, 陈树丹, 卢健聪, 等. 基于症状的COPD筛查问卷对COPD高危人员的相关性研究. 中外医疗, 2014, 33(13): 155-156.
36.	徐宪韬, 吴丰芹, 徐琴. COPD风险七项评分量表在COPD早期筛查中的应用价值. 现代医药卫生, 2018, 34(20): 3152-3155.
37.	姚艳颜, 田禾燊, 吴繁, 等. 慢性阻塞性肺病筛查问卷(COPD-SQ)在社区中的应用评价. 广州医科大学学报, 2021, 49(3): 41-46.
38.	周为. 慢性阻塞性肺疾病基层简易筛查问卷的建立及验证研究. 北京: 北京协和医学院, 2021.
39.	吴景玲, 葛龙, 张俊华, 等. 多个诊断性试验准确性的比较: 网状Meta分析方法介绍. 中国循证医学杂志, 2017, 17(8): 987-992.
40.	刘芬. 诊断试验研究在医学科研中的理论、设计和实践. 北京医学, 2020, 42(11): 1151-1155.
41.	Yawn BP, Mapel DW, Mannino DM, et al. Development of the lung function questionnaire (LFQ) to identify airflow obstruction. Int J Chron Obstruct Pulmon Dis, 2010, 5: 1-10.
42.	Zhou YM, Chen SY, Tian J, et al. Development and validation of a chronic obstructive pulmonary disease screening questionnaire in China. Int J Tuberc Lung Dis, 2013, 17(12): 1645-1651.
43.	Gu Y, Zhang Y, Wen Q, et al. Performance of COPD population screener questionnaire in COPD screening: a validation study and meta-analysis. Ann Med, 2021, 53(1): 1198-1206.

1. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
2. 王秀秀. 饮食及体力活动因素与老年慢性阻塞性肺疾病关系的病例-对照研究. 石家庄: 河北医科大学, 2021.
3. 包鹤龄, 方利文, 王临虹. 1990-2014年中国40岁及以上人群慢性阻塞性肺疾病患病率Meta分析. 中华流行病学杂志, 2016, 37(1): 119-124.
4. 韩丁. 三种问卷在慢性阻塞性肺疾病中的筛查价值. 昆明: 昆明医科大学, 2020.
5. 赵海金, 赵文驱, 彭显如. 重视慢性阻塞性肺疾病的早期诊断和早期干预. 实用医学杂志, 2018, 34(21): 3493-3495.
6. 王明航, 毕丽婵, 赵欢欢, 等. 慢性阻塞性肺疾病早期筛查技术应用研究进展. 中国老年学杂志, 2022, 42(10): 2529-2532.
7. 柳月, 袁媛. 慢性阻塞性肺疾病筛查工具准确性的网状Meta分析. 中国全科医学, 2022, 25(35): 4443-4452.
8. 2022 GOLD Reports. Global initiative for chronic obstructive lung disease, 2022/7/14. Available at:https://goldcopd.org/2022-gold-reports-2/.
9. 曹慧慧. 超声、X线、CT对诊断血胸价值的Meta分析及超声对血胸定量诊断研究. 兰州: 甘肃中医药大学, 2018.
10. 王玲, 王梦书, 周奇. 超声诊断尺桡骨远端骨折价值的系统评价. 中国循证医学杂志, 2017, 17(2): 213-220.
11. 张天嵩, 钟文昭. Meta-DiSc软件在诊断试验Meta分析中的应用. 循证医学, 2008, 8(2): 97-100,108.
12. Frith P, Crockett A, Beilby J, et al. Simplified COPD screening: validation of the PiKo-6® in primary care. Prim Care Respir J, 2011, 20(2): 190-198.
13. Jarhyan P, Hutchinson A, Khatkar R, et al. Diagnostic accuracy of a two-stage sequential screening strategy implemented by community health workers (CHWs) to identify individuals with COPD in rural India. Int J Chron Obstruct Pulmon Dis, 2021, 16: 1183-1192.
14. Kotz D, Nelemans P, van Schayck CP, et al. External validation of a COPD diagnostic questionnaire. Eur Respir J, 2008, 31(2): 298-303.
15. Llordés M, Zurdo E, Jaén Á, et al. Which is the Best Screening Strategy for COPD among Smokers in Primary Care. COPD, 2017, 14(1): 43-51.
16. Martinez FJ, Raczek AE, Seifer FD, et al. Development and initial validation of a self-scored COPD Population Screener Questionnaire (COPD-PS). COPD, 2008, 5(2): 85-95.
17. Mintz ML, Yawn BP, Mannino DM, et al. Prevalence of airway obstruction assessed by lung function questionnaire. Mayo Clin Proc, 2011, 86(5): 375-381.
18. Price DB, Tinkelman DG, Nordyke RJ, et al. Scoring system and clinical application of COPD diagnostic questionnaires. Chest, 2006, 129(6): 1531-1539.
19. Ronaldson SJ, Dyson L, Clark L, et al. Determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease: The DOC study. J Eval Clin Pract, 2018, 24(3): 487-495.
20. Sichletidis L, Spyratos D, Papaioannou M, et al. A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting. Prim Care Respir J, 2011, 20(2): 184-189.
21. Soriano JB, Molina J, Miravitlles M. Combining case-finding methods for COPD in primary care: a large, two-stage design study. Int J Tuberc Lung Dis, 2018, 22(1): 106-111.
22. Spyratos D, Haidich AB, Chloros D, et al. Comparison of three screening questionnaires for chronic obstructive pulmonary disease in the primary care. Respiration, 2017, 93(2): 83-89.
23. Stanley AJ, Hasan I, Crockett AJ, et al. COPD Diagnostic Questionnaire (CDQ) for selecting at-risk patients for spirometry: a cross-sectional study in Australian general practice. NPJ Prim Care Respir Med, 2014, 24: 14024.
24. Tsukuya G, Samukawa T, Matsumoto K, et al. Comparison of the COPD population screener and international primary care airway group questionnaires in a general Japanese population: the Hisayama study. Int J Chron Obstruct Pulmon Dis, 2016, 11: 1903-1909.
25. Tsukuya G, Matsumoto K, Fukuyama S, et al. Validation of a COPD screening questionnaire and establishment of diagnostic cut-points in a Japanese general population: the Hisayama study. Allergol Int, 2015, 64(1): 49-53.
26. 陈淑云. 慢性阻塞性肺病社区综合防治适宜技术的初步研究. 广州: 广州医科大学, 2014.
27. 杜明明, 董礼, 吕俊. 两种方法筛查宜宾市60岁以上居民慢性阻塞性肺疾病的一致性研究. 实用老年医学, 2021, 35(2): 141-144.
28. 葛妍麟, 陈红, 杨嫦娟. 基于症状的慢性阻塞性肺疾病筛查问卷在社区人群中的应用. 当代护士(下旬刊), 2014, (11): 124-125.
29. 吉珉. 筛查问卷与肺功能检查在宁海山区老年人慢阻肺诊断中的应用价值分析. 医药前沿, 2019, 9(20): 254.
30. 李云海, 李俊, 张楠, 等. 慢阻肺筛查问卷加肺功能检查对慢阻肺的早期诊断作用研究. 世界最新医学信息文摘, 2019, 19(61): 246-247.
31. 刘妍, 邓笑伟. 筛查问卷与肺功能检查在慢性阻塞性肺疾病早期诊断中的研究. 临床肺科杂志, 2015, 20(3): 500-503.
32. 石喆, 王石林, 汪海燕, 等. 适宜国人BMI分级的慢性阻塞性肺疾病筛查问卷的检验与评价. 中华全科医师杂志, 2014, 13(3): 184-187.
33. 陶学芳, 邵银燕, 孙金军, 等. 基于症状的慢性阻塞性肺疾病筛查问卷诊断效果评价. 预防医学, 2019, 31(7): 693-695.
34. 王娟, 许文兵, 曾学军, 等. 中文版慢性阻塞性肺疾病筛查问卷在吸烟者中的初步检验与评价. 中华内科杂志, 2012, 51(4): 311-312.
35. 王石林, 陈树丹, 卢健聪, 等. 基于症状的COPD筛查问卷对COPD高危人员的相关性研究. 中外医疗, 2014, 33(13): 155-156.
36. 徐宪韬, 吴丰芹, 徐琴. COPD风险七项评分量表在COPD早期筛查中的应用价值. 现代医药卫生, 2018, 34(20): 3152-3155.
37. 姚艳颜, 田禾燊, 吴繁, 等. 慢性阻塞性肺病筛查问卷(COPD-SQ)在社区中的应用评价. 广州医科大学学报, 2021, 49(3): 41-46.
38. 周为. 慢性阻塞性肺疾病基层简易筛查问卷的建立及验证研究. 北京: 北京协和医学院, 2021.
39. 吴景玲, 葛龙, 张俊华, 等. 多个诊断性试验准确性的比较: 网状Meta分析方法介绍. 中国循证医学杂志, 2017, 17(8): 987-992.
40. 刘芬. 诊断试验研究在医学科研中的理论、设计和实践. 北京医学, 2020, 42(11): 1151-1155.
41. Yawn BP, Mapel DW, Mannino DM, et al. Development of the lung function questionnaire (LFQ) to identify airflow obstruction. Int J Chron Obstruct Pulmon Dis, 2010, 5: 1-10.
42. Zhou YM, Chen SY, Tian J, et al. Development and validation of a chronic obstructive pulmonary disease screening questionnaire in China. Int J Tuberc Lung Dis, 2013, 17(12): 1645-1651.
43. Gu Y, Zhang Y, Wen Q, et al. Performance of COPD population screener questionnaire in COPD screening: a validation study and meta-analysis. Ann Med, 2021, 53(1): 1198-1206.

Chinese Journal of Evidence-Based Medicine

Screening accuracy for four common questionnaires of chronic obstructive pulmonary disease: a network meta-analysis

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