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. 飲食及體力活動因素與老年慢性阻塞性肺疾病關系的病例-對照研究. 石家莊: 河北醫科大學, 2021.
3.	包鶴齡, 方利文, 王臨虹. 1990-2014年中國40歲及以上人群慢性阻塞性肺疾病患病率Meta分析. 中華流行病學雜志, 2016, 37(1): 119-124.
4.	韓丁. 三種問卷在慢性阻塞性肺疾病中的篩查價值. 昆明: 昆明醫科大學, 2020.
5.	趙海金, 趙文驅, 彭顯如. 重視慢性阻塞性肺疾病的早期診斷和早期干預. 實用醫學雜志, 2018, 34(21): 3493-3495.
6.	王明航, 畢麗嬋, 趙歡歡, 等. 慢性阻塞性肺疾病早期篩查技術應用研究進展. 中國老年學雜志, 2022, 42(10): 2529-2532.
7.	柳月, 袁媛. 慢性阻塞性肺疾病篩查工具準確性的網狀Meta分析. 中國全科醫學, 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. 超聲、X線、CT對診斷血胸價值的Meta分析及超聲對血胸定量診斷研究. 蘭州: 甘肅中醫藥大學, 2018.
10.	王玲, 王夢書, 周奇. 超聲診斷尺橈骨遠端骨折價值的系統評價. 中國循證醫學雜志, 2017, 17(2): 213-220.
11.	張天嵩, 鐘文昭. Meta-DiSc軟件在診斷試驗Meta分析中的應用. 循證醫學, 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.	陳淑云. 慢性阻塞性肺病社區綜合防治適宜技術的初步研究. 廣州: 廣州醫科大學, 2014.
27.	杜明明, 董禮, 呂俊. 兩種方法篩查宜賓市60歲以上居民慢性阻塞性肺疾病的一致性研究. 實用老年醫學, 2021, 35(2): 141-144.
28.	葛妍麟, 陳紅, 楊嫦娟. 基于癥狀的慢性阻塞性肺疾病篩查問卷在社區人群中的應用. 當代護士(下旬刊), 2014, (11): 124-125.
29.	吉珉. 篩查問卷與肺功能檢查在寧海山區老年人慢阻肺診斷中的應用價值分析. 醫藥前沿, 2019, 9(20): 254.
30.	李云海, 李俊, 張楠, 等. 慢阻肺篩查問卷加肺功能檢查對慢阻肺的早期診斷作用研究. 世界最新醫學信息文摘, 2019, 19(61): 246-247.
31.	劉妍, 鄧笑偉. 篩查問卷與肺功能檢查在慢性阻塞性肺疾病早期診斷中的研究. 臨床肺科雜志, 2015, 20(3): 500-503.
32.	石喆, 王石林, 汪海燕, 等. 適宜國人BMI分級的慢性阻塞性肺疾病篩查問卷的檢驗與評價. 中華全科醫師雜志, 2014, 13(3): 184-187.
33.	陶學芳, 邵銀燕, 孫金軍, 等. 基于癥狀的慢性阻塞性肺疾病篩查問卷診斷效果評價. 預防醫學, 2019, 31(7): 693-695.
34.	王娟, 許文兵, 曾學軍, 等. 中文版慢性阻塞性肺疾病篩查問卷在吸煙者中的初步檢驗與評價. 中華內科雜志, 2012, 51(4): 311-312.
35.	王石林, 陳樹丹, 盧健聰, 等. 基于癥狀的COPD篩查問卷對COPD高危人員的相關性研究. 中外醫療, 2014, 33(13): 155-156.
36.	徐憲韜, 吳豐芹, 徐琴. COPD風險七項評分量表在COPD早期篩查中的應用價值. 現代醫藥衛生, 2018, 34(20): 3152-3155.
37.	姚艷顏, 田禾燊, 吳繁, 等. 慢性阻塞性肺病篩查問卷(COPD-SQ)在社區中的應用評價. 廣州醫科大學學報, 2021, 49(3): 41-46.
38.	周為. 慢性阻塞性肺疾病基層簡易篩查問卷的建立及驗證研究. 北京: 北京協和醫學院, 2021.
39.	吳景玲, 葛龍, 張俊華, 等. 多個診斷性試驗準確性的比較: 網狀Meta分析方法介紹. 中國循證醫學雜志, 2017, 17(8): 987-992.
40.	劉芬. 診斷試驗研究在醫學科研中的理論、設計和實踐. 北京醫學, 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. 飲食及體力活動因素與老年慢性阻塞性肺疾病關系的病例-對照研究. 石家莊: 河北醫科大學, 2021.
3. 包鶴齡, 方利文, 王臨虹. 1990-2014年中國40歲及以上人群慢性阻塞性肺疾病患病率Meta分析. 中華流行病學雜志, 2016, 37(1): 119-124.
4. 韓丁. 三種問卷在慢性阻塞性肺疾病中的篩查價值. 昆明: 昆明醫科大學, 2020.
5. 趙海金, 趙文驅, 彭顯如. 重視慢性阻塞性肺疾病的早期診斷和早期干預. 實用醫學雜志, 2018, 34(21): 3493-3495.
6. 王明航, 畢麗嬋, 趙歡歡, 等. 慢性阻塞性肺疾病早期篩查技術應用研究進展. 中國老年學雜志, 2022, 42(10): 2529-2532.
7. 柳月, 袁媛. 慢性阻塞性肺疾病篩查工具準確性的網狀Meta分析. 中國全科醫學, 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. 超聲、X線、CT對診斷血胸價值的Meta分析及超聲對血胸定量診斷研究. 蘭州: 甘肅中醫藥大學, 2018.
10. 王玲, 王夢書, 周奇. 超聲診斷尺橈骨遠端骨折價值的系統評價. 中國循證醫學雜志, 2017, 17(2): 213-220.
11. 張天嵩, 鐘文昭. Meta-DiSc軟件在診斷試驗Meta分析中的應用. 循證醫學, 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. 陳淑云. 慢性阻塞性肺病社區綜合防治適宜技術的初步研究. 廣州: 廣州醫科大學, 2014.
27. 杜明明, 董禮, 呂俊. 兩種方法篩查宜賓市60歲以上居民慢性阻塞性肺疾病的一致性研究. 實用老年醫學, 2021, 35(2): 141-144.
28. 葛妍麟, 陳紅, 楊嫦娟. 基于癥狀的慢性阻塞性肺疾病篩查問卷在社區人群中的應用. 當代護士(下旬刊), 2014, (11): 124-125.
29. 吉珉. 篩查問卷與肺功能檢查在寧海山區老年人慢阻肺診斷中的應用價值分析. 醫藥前沿, 2019, 9(20): 254.
30. 李云海, 李俊, 張楠, 等. 慢阻肺篩查問卷加肺功能檢查對慢阻肺的早期診斷作用研究. 世界最新醫學信息文摘, 2019, 19(61): 246-247.
31. 劉妍, 鄧笑偉. 篩查問卷與肺功能檢查在慢性阻塞性肺疾病早期診斷中的研究. 臨床肺科雜志, 2015, 20(3): 500-503.
32. 石喆, 王石林, 汪海燕, 等. 適宜國人BMI分級的慢性阻塞性肺疾病篩查問卷的檢驗與評價. 中華全科醫師雜志, 2014, 13(3): 184-187.
33. 陶學芳, 邵銀燕, 孫金軍, 等. 基于癥狀的慢性阻塞性肺疾病篩查問卷診斷效果評價. 預防醫學, 2019, 31(7): 693-695.
34. 王娟, 許文兵, 曾學軍, 等. 中文版慢性阻塞性肺疾病篩查問卷在吸煙者中的初步檢驗與評價. 中華內科雜志, 2012, 51(4): 311-312.
35. 王石林, 陳樹丹, 盧健聰, 等. 基于癥狀的COPD篩查問卷對COPD高危人員的相關性研究. 中外醫療, 2014, 33(13): 155-156.
36. 徐憲韜, 吳豐芹, 徐琴. COPD風險七項評分量表在COPD早期篩查中的應用價值. 現代醫藥衛生, 2018, 34(20): 3152-3155.
37. 姚艷顏, 田禾燊, 吳繁, 等. 慢性阻塞性肺病篩查問卷(COPD-SQ)在社區中的應用評價. 廣州醫科大學學報, 2021, 49(3): 41-46.
38. 周為. 慢性阻塞性肺疾病基層簡易篩查問卷的建立及驗證研究. 北京: 北京協和醫學院, 2021.
39. 吳景玲, 葛龍, 張俊華, 等. 多個診斷性試驗準確性的比較: 網狀Meta分析方法介紹. 中國循證醫學雜志, 2017, 17(8): 987-992.
40. 劉芬. 診斷試驗研究在醫學科研中的理論、設計和實踐. 北京醫學, 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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