title: Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings.
abstract: OBJECTIVE
  The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings.
  
  
  METHODS
  Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh).
  
  
  METHODS
  individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis.
  
  
  RESULTS
  437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performance in the different settings and also regarding age, gender and smoking status.
  
  
  CONCLUSIONS
  The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8.
authors.affiliation: Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Represas-Represas
authors.affiliation: Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-Villar
authors.affiliation: Department of Preventive Medicine and PublicHealth, University of Santiago de Compostela, Santiago de Compostela, Spain, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ruano-Raviña
authors.affiliation: Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Priegue-Carrera
authors.affiliation: Pulmonology Department, NeumoVigoI+i Research Group, University Hospital Complex of Vigo (CHUVI), Estructura Organizativa de Xestión Integrada de Vigo (EOXI Vigo), BiomedicalResearchInstitute of Vigo (IBIV), Vigo, Spain.
authors.forename: Maribel
authors.initials: M
authors.lastname: Botana-Rial
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D015203:Reproducibility of Results