title: Development and validation of a screening tool for chronic obstructive pulmonary disease in nursing home residents.
abstract: OBJECTIVE
  The purpose of the study was to develop and validate a simple caregiver-rated questionnaire to screen for chronic obstructive pulmonary disease (COPD) in nursing home residents.
  
  
  METHODS
  Part 1: Identification of screening parameters by the Delphi process using geriatric and pulmonary experts. Part 2: Retrospective analysis of nursing home residents with COPD compared with a gender and age frequency-matched control group of nursing home residents.
  
  
  METHODS
  Twelve skilled nursing facilities in Arizona, California, Illinois, Maryland, Missouri, and Ohio.
  
  
  METHODS
  Nine geriatric and pulmonary experts participated in the identification of screening parameters in Part 1. In Part 2, validation occurred in 64 nursing home residents with COPD and 64 nursing home residents without COPD.
  
  
  METHODS
  Retrospective analysis of medical records.
  
  
  METHODS
  A linear logistic regression routine was used with a stepwise algorithm to identify a "best" set of variables predicting the presence of COPD. The list of variables chosen was then used to define a predictive role for COPD. This role was then characterized by its screening characteristics of sensitivity and specificity.
  
  
  RESULTS
  The logistic model identified 4 significant COPD screening parameters: diagnosis of asthma (P = .013), shortness of breath at rest (P = .004) and shortness of breath on exertion (P = .001), and smoking fewer than 19 pack-years (P = .005) or greater than or equal to 19 pack-years (P = .001), with an area-under-the-curve of 0.903.
  
  
  CONCLUSIONS
  Nursing home residents with a diagnosis of asthma and have shortness of breath or have been smokers are likely to have COPD.
authors: Wayne State University and Omnicare, Inc., Livonia, MI, USA. barbara.zarowitz@omnicare.com
authors: Barbara J
authors: BJ
authors: Zarowitz
authors: Terrence
authors: T
authors: O'Shea
authors: Allen
authors: A
authors: Lefkovitz
authors: Edward L
authors: EL
authors: Peterson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States