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      La evaluación con el cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD - 6 como estrategia para el diagnóstico temprano de la EPOC en la atención primaria Translated title: Evaluation with COPD-PS questionnaire and Vitalograph COPD-6 portable device as a strategy for early diagnosis of COPD in primary care

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          Abstract

          RESUMEN Objetivo: evaluar el uso del cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD- 6, como estrategia para el diagnóstico temprano de la enfermedad pulmonar obstructiva crónica (EPOC) en dos unidades de atención primaria de la empresa social del estado (E.S.E): Metrosalud, Medellín-Colombia en 2017. Métodos: estudio transversal de detección temprana de la EPOC, en personas mayores de 35 años sin diagnóstico previo de la enfermedad u otras complicaciones respiratorias subyacen-tes, a las cuales se les aplicó la prueba de tamizaje de COPD-PS para identificar factores de riesgo respiratorio y, posteriormente, la prueba de volumen espiratorio forzado (VEF1/VEF6) con el dispositivo portátil Vitalograph COPD-6. Resultados: de 1.485 pruebas de tamizaje COPD-PS, 198 presentaron un puntaje igual o su-perior a 4, por lo que se les realizó la prueba con el dispositivo Vitalograph. De los cuales, 147 (74,2 %) resultaron positivos. Discusión: el subregistro de la EPOC se describe actualmente como un grave problema mundial. El uso del cuestionario COPD-PS para la identificación de pacientes con factores de riesgo y del Vitalograph COPD-6 como prueba de función pulmonar, pueden ser herramientas útiles para implementar una estrategia efectiva en la reducción del subregistro de la EPOC.

          Translated abstract

          SUMMARY Objective: To evaluate the use of the COPD-PS questionnaire and the Vitalograph COPD-6 portable device, as a strategy for the early diagnosis of chronic obstructive pulmonary disease (COPD) in two primary care units of the state social enterprise (ESE): Metrosalud, Medellin-Colombia in 2017. Methods: A cross-sectional study to early detection of COPD, in people older than 35 years without previous diagnosis of the disease or other underlying respiratory diseases. The “COPD-PS” case detection-screening test was applied for identify respiratory risk fac-tors and then the forced expiratory volume test (VEF1/VEF6) with the portable device Vitalograph-COPD-6. Results: Of 1485 COPD-PS screening tests, 198 had a score equal to or greater than four, so they were tested with the Vitalograph device, of which 147 (74.2%) were positive. Discussion: The underreporting of Chronic Obstructive Pulmonary Disease (COPD) is currently described as a serious problem worldwide. The use of the COPD-PS questionnaire for the identification of patients with risk factors and the Vitalograph COPD-6 as a lung function test, can be useful tools to implement an effective strategy to reduce COPD underreporting.

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          Most cited references42

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          Development and first validation of the COPD Assessment Test.

          There is need for a validated short, simple instrument to quantify chronic obstructive pulmonary disease (COPD) impact in routine practice to aid health status assessment and communication between patient and physician. Current health-related quality of life questionnaires provide valid assessment of COPD, but are complex, which limits routine use. The aim of the present study was to develop a short validated patient-completed questionnaire, the COPD Assessment Test (CAT), assessing the impact of COPD on health status. 21 candidate items identified through qualitative research with COPD patients were used in three prospective international studies (Europe and the USA, n = 1,503). Psychometric and Rasch analyses identified eight items fitting a unidimensional model to form the CAT. Items were tested for differential functioning between countries. Internal consistency was excellent: Cronbach's alpha = 0.88. Test re-test in stable patients (n = 53) was very good (intra-class correlation coefficient 0.8). In the sample from the USA, the correlation with the COPD-specific version of the St George's Respiratory Questionnaire was r = 0.80. The difference between stable (n = 229) and exacerbation patients (n = 67) was five units of the 40-point scale (12%; p<0.0001). The CAT is a short, simple questionnaire for assessing and monitoring COPD. It has good measurement properties, is sensitive to differences in state and should provide a valid, reliable and standardised measure of COPD health status with worldwide relevance.
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            Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society.

            This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable chronic obstructive pulmonary disease (COPD) and is intended for clinicians who manage patients with COPD. This guideline addresses the value of history and physical examination for predicting airflow obstruction; the value of spirometry for screening or diagnosis of COPD; and COPD management strategies, specifically evaluation of various inhaled therapies (anticholinergics, long-acting β-agonists, and corticosteroids), pulmonary rehabilitation programs, and supplemental oxygen therapy. This guideline is based on a targeted literature update from March 2007 to December 2009 to evaluate the evidence and update the 2007 ACP clinical practice guideline on diagnosis and management of stable COPD. RECOMMENDATION 1: ACP, ACCP, ATS, and ERS recommend that spirometry should be obtained to diagnose airflow obstruction in patients with respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). Spirometry should not be used to screen for airflow obstruction in individuals without respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). RECOMMENDATION 2: For stable COPD patients with respiratory symptoms and FEV(1) between 60% and 80% predicted, ACP, ACCP, ATS, and ERS suggest that treatment with inhaled bronchodilators may be used (Grade: weak recommendation, low-quality evidence). RECOMMENDATION 3: For stable COPD patients with respiratory symptoms and FEV(1) 50% predicted. (Grade: weak recommendation, moderate-quality evidence). RECOMMENDATION 7: ACP, ACCP, ATS, and ERS recommend that clinicians should prescribe continuous oxygen therapy in patients with COPD who have severe resting hypoxemia (Pao(2) ≤55 mm Hg or Spo(2) ≤88%) (Grade: strong recommendation, moderate-quality evidence).
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              Determinants of underdiagnosis of COPD in national and international surveys.

              COPD ranks within the top three causes of mortality in the global burden of disease, yet it remains largely underdiagnosed. We assessed the underdiagnosis of COPD and its determinants in national and international surveys of general populations.
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                Author and article information

                Journal
                iat
                Iatreia
                Iatreia
                Universidad de Antioquia (Medellín, Antioquia, Colombia )
                0121-0793
                September 2020
                : 33
                : 3
                : 229-238
                Affiliations
                [1] Medellín orgnameIPS Colombia Saludable Colombia
                [3] Medellín orgnameIPS Colombia Saludable Colombia
                [2] Medellín Antioquía orgnameCorporación Universitaria Remington Colombia
                Article
                S0121-07932020000300229 S0121-0793(20)03300300229
                10.17533/udea.iatreia.44
                7927ed7c-a98a-44b4-bcee-e3f766ff57a7

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 16 September 2019
                : 23 May 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 10
                Product

                SciELO Colombia

                Categories
                Artículos originales

                Volumen Espiratorio Forzado,Tamizaje Masivo,Mediciones del Volumen Pulmonar,Risk Factors,Mass Screening,Factores de Riesgo,Pulmonary Disease, Chronic Obstructive,Enfermedad Pulmonar Obstructiva Crónica,Forced Expirator Volume,Lung Volume Measurements

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