title: VitalQPlus: a potential screening tool for early diagnosis of COPD.
abstract: BACKGROUND
  This study utilized a validated combination of a COPD Population Screener (COPD-PS) questionnaire and a handheld spirometric device as a screening tool for patients at high risk of COPD, such as smokers. The study aimed to investigate and pilot the feasibility and application of this combined assessment, which we termed the "VitalQPlus", as a screening tool for the early detection of COPD, especially in primary care settings.
  
  
  METHODS
  This was a cross-sectional study screening potentially undiagnosed COPD patients using a validated five-item COPD-PS questionnaire together with a handheld spirometric device. Patients were recruited from selected Malaysian government primary care health centers.
  
  
  RESULTS
  Of the total of 83 final participants, only 24.1% (20/83) were recruited from Perak and Penang (peninsular Malaysia) compared to 75.9% (63/83) from Sabah (Borneo region). Our dual assessment approach identified 8.4% of the surveyed patients as having potentially undiagnosed COPD. When only the Vitalograph COPD-6 screening tool was used, 15.8% of patients were detected with a forced expiratory volume in 1 second/forced expiratory volume in 6 seconds (FEV1/FEV6) ratio at <0.75, while 35.9% of patients were detected with the COPD-PS questionnaire. These findings suggested that this dual assessment approach has a greater chance of identifying potentially undiagnosed COPD patients compared to the Vitalograph COPD-6 or COPD-PS questionnaire when used alone. Our findings show that patients with more symptoms (scores of ≥5) yielded twice the percentage of outcomes of FEV1/FEV6 <0.75 compared to patients with fewer COPD symptoms (scores <5).
  
  
  CONCLUSIONS
  With the availability of a simple screening questionnaire and the COPD-6, there is an opportunity easily to make patients more aware of their lung symptoms and to encourage the provision of early treatment. The proposed dual assessment approach, which we termed the VitalQPlus, may play a profound role in the early diagnosis of COPD, which is crucial in improving the clinical management of the disease.
authors: School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
authors: Chee Fai
authors: CF
authors: Sui
authors: Faculty of Pharmacy, Universiti Teknologi MARA, UiTM, Selangor, Malaysia ; Brain Degeneration and Therapeutics Group, Pharmaceutical and Life Sciences (PLS) Community of Research (CoRe), UiTM, Selangor, Malaysia.
authors: Long Chiau
authors: LC
authors: Ming
authors: Faculty of Pharmacy, Universiti Teknologi MARA, UiTM, Selangor, Malaysia ; Collaborative Drug Discovery Research (CDDR) Group, Pharmaceutical and Life Sciences (PLS) Community of Research (CoRe), UiTM, Selangor, Malaysia.
authors: Chin Fen
authors: CF
authors: Neoh
authors: School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
authors: Baharudin
authors: B
authors: Ibrahim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013147:Spirometry / Q000295:instrumentation; D011795:Surveys and Questionnaires
keywords: airway obstruction; chronic obstructive pulmonary disease; pulmonary function test; spirometry