Analysis of the prevalence and improvement of the methodology for COPD identification in outpatientpolyclinic practice


DOI: https://dx.doi.org/10.18565/therapy.2019.5.45-52

Dolbin S.S., Adasheva T.V., Zadionchenko V.S., Malyavin A.G., Pavlov S.V., Babak S.L.

1) Central polyclinic, Moscow 2) A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia
The purpose – to study the prevalence of COPD and develop algorithms for COPD diagnosing on outpatient basis.
Material and methods. The observation group consisted of a random sample of 1000 persons aged 40 to 75 years of the attached contingent of an outpatient institution with departmental subordination. The group of examined persons had no professional risk factors for COPD development, it had a high socio-economical status and educational level (94% – higher education). After exclusion of patients with bronchopulmonary pathology (cancer, tuberculosis) and patients who refused from the study, a screening was performed, which included spirometry, CAT assessment test and CAD questionnaire.
Results. 917 persons were examined. 41 patient was revealed, meeting the criteria for COPD diagnosis (only 2 patients had this diagnosis before screening). The prevalence of COPD was 4,1% (before screening 0,2%), which is almost 3 times higher than the average statistics shows. The estimation of predictive ability of routine questionnaires (CAT and CAD) was made, the ROC curve (Receiver Operating Characteristic) was constructed. The area under the ROC curve (AUC) for the CAT assessment test was 0,895 (95% CI 0,85–0,93). The threshold value for the CAT test is 7,5. The ROC AUC for the CAD questionnaire consisted 0,89 (95% CI 0,83–0,94). Threshold value CAD=10,5.
Conclusion. Both tests (CAD and CAT) have good prognostication potential and can be used for screening on an outpatient basis and selecting patients for further spirometry for early COPD diagnosis performance.
Keywords: chronic obstructive pulmonary disease, prevalence, COPD detection algorithm
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About the Autors

Sergey S. Dolbin, district physician of Central polyclinic. Address: 107031, Moscow, 5 Varsonofievsky Lane. E-mail: sdolbin@yandex.ru
Tatyana V. Adasheva, MD, professor of the Department of outpatient therapy of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: adashtv@mail.ru
VladimirS. Zadionchenko, MD, professor of the Department of outpatient therapy of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: z7vladimir@bk.ru
Andrei G. Malyavin, MD, professor of the Department of phthisiology and pulmonology of the faculty of general medicine of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: maliavin@mail.ru
Sergey V. Pavlov, PhD, assistant of the Department of outpatient therapy of FSBEI of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: paseva@list.ru
Sergey L. Babak, MD, professor of the Department of phthisiology and pulmonology of the faculty of general medicine of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: sergbabak@mail.ru

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