title: Comparison of the COPD Population Screener and International Primary Care Airway Group questionnaires in a general Japanese population: the Hisayama study.
abstract: BACKGROUND
  The incidence of chronic obstructive pulmonary disease (COPD) is increasing worldwide. In Japan and other countries, epidemiological studies have found that many patients with COPD are underdiagnosed and untreated, and thus, early detection and treatment of COPD has been emphasized. Screening questionnaires may have utility in the initial detection of COPD.
  
  
  OBJECTIVE
  This study aimed to validate and compare the COPD Population Screener (COPD-PS) and the International Primary Care Airway Group (IPAG) questionnaires in a general Japanese population.
  
  
  METHODS
  Eligible subjects 40 years of age and older living in the town of Hisayama were solicited to participate in a health checkup in 2012. All subjects 40-79 years of age without physician-diagnosed asthma or lung resection were recruited, and 2,336 subjects who fully completed both questionnaires and who had valid spirometry measurements were analyzed. Persistent airflow obstruction (AO) was defined by a postbronchodilator forced expiratory volume in 1 second/forced vital capacity <0.70. Receiver operating characteristic curves, net reclassification improvement, and integrated discrimination improvement were used to examine the ability of the COPD-PS and IPAG questionnaires to discriminate between subjects with and without AO.
  
  
  RESULTS
  The overall area under the receiver operating characteristic curve for the COPD-PS questionnaire was 0.747 (95% confidence interval [CI], 0.707-0.788) and for the IPAG was 0.775 (95% CI, 0.735-0.816), with no significant difference (P=0.09). The net reclassification improvement and integrated discrimination improvement were -0.107 (95% CI, -0.273-0.058; P=0.203) and -0.014 (95% CI, -0.033-0.006; P=0.182), respectively.
  
  
  CONCLUSIONS
  The five-item COPD-PS questionnaire was comparable to the eight-item IPAG for discriminating between subjects with and without AO. The COPD-PS is a simple and useful screening questionnaire for persistent AO.
authors: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima.
authors: Go
authors: G
authors: Tsukuya
authors: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima.
authors: Takuya
authors: T
authors: Samukawa
authors: Reasearch Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors: Koichiro
authors: K
authors: Matsumoto
authors: Reasearch Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors: Satoru
authors: S
authors: Fukuyama
authors: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima.
authors: Tomohiro
authors: T
authors: Kumamoto
authors: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima.
authors: Akifumi
authors: A
authors: Uchida
authors: Department of Epidemiology and Preventive Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima.
authors: Chihaya
authors: C
authors: Koriyama
authors: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Toshiharu
authors: T
authors: Ninomiya
authors: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima.
authors: Hiromasa
authors: H
authors: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D013147:Spirometry; D011795:Surveys and Questionnaires
keywords: COPD screening; Japanese population; airflow obstruction; bronchodilator; pulmonary function tests; questionnaires