Simple Tools May Help Diagnose COPD Earlier, Study Suggests

Despite the fact that there is emerging international agreement on diagnostic criteria for chronic obstructive pulmonary disease (COPD), patients with COPD may go undiagnosed—or may be incorrectly diagnosed—for a variety of reasons, including the cost and availability of electronic spirometry and other lung function testing. However, new research suggests that relatively simple measures may be able to provide effective screening for COPD that will allow patients to be diagnosed earlier and with greater reliability.

In a study recently published in Respirology, investigators sought to identify the benefit of using a handheld flow meter in screening patients for COPD.

The study enrolled 2008 participants, all of whom were aged 40 years or older, in Japan. The investigators developed 2 novel points-based systems for detecting COPD, one of which used a handheld flow meter on its own, and the other of which also incorporated the score of the International Primary Care Airway Group questionnaire (IPAG), which includes questions related to smoking, body mass index, and symptoms, together with the flow meter. They then used validation of random sample allocation to assess the predictive value of these 2 models.

Decision curve analysis showed that the net benefits of using both models were higher than the benefits of using IPAG scores alone, and they reported that the study demonstrated that the use of a handheld flow meter was “significantly advantageous” in detecting COPD.

Using the relatively simple tools of a handheld flow meter together with a validated questionnaire may be able to help detect COPD in patients at an earlier stage. The challenge, wrote Peter A. Frith, MBBS, FRACP, FThorSoc, of Flinders University in Adelaide, Australia, in a linked editorial, is that the burden lies with healthcare professionals to make changes to their practice to ensure that they can detect cases of COPD and initiate effective treatment for affected patients “before disablement has become entrenched, with all its personal and societal costs.”

Frith added that, while establishing and sustaining behavioral change among providers is challenging, “there are simple tools available…and we need to learn how best to incorporate them into health care.”

1. Fujita M, Nagashima K, Takahashi S, Suzuki K, Fujisawa T, Hata A. Handheld flow meter improves COPD detectability regardless of using a conventional questionnaire: a split-sample validation study [published online June 12, 2019]. Respirology. doi: 10.1111/resp.13602

2. Frith PA. Detecting COPD using micro-spirometry and/or questionnaire [published online July 10, 2019]. Respirology. doi: 10.1111/resp.13636.

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