Can CAPTURE be used to identify undiagnosed patients with mild-to-moderate COPD likely to benefit from treatment?

Abstract

Background

COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE™) uses five questions and peak expiratory flow (PEF) thresholds (males ≤350 L/min; females ≤250 L/min) to identify patients with a forced expiratory volume in 1 second (FEV ₁)/forced vital capacity (FVC) <0.70 and FEV ₁ <60% predicted or exacerbation risk requiring further evaluation for COPD. This study tested CAPTURE’s ability to identify symptomatic patients with mild-to-moderate COPD (FEV ₁ 60%–80% predicted) who may also benefit from diagnosis and treatment.

Methods

Data from the CAPTURE development study were used to test its sensitivity (SN) and specificity (SP) differentiating mild-to-moderate COPD (n=73) from no COPD (n=87). SN and SP for differentiating all COPD cases (mild to severe; n=259) from those without COPD (n=87) were also estimated. The modified Medical Research Council (mMRC) dyspnea scale and COPD Assessment Test (CAT™) were used to evaluate symptoms and health status. Clinical Trial Registration: NCT01880177, https://ClinicalTrials.gov/ct2/show/NCT01880177?term=NCT01880177&rank=1.

Results

Mean age (+SD): 61 (+10.5) years; 41% male. COPD: FEV ₁/FVC=0.60 (+0.1), FEV ₁% predicted=74% (+12.4). SN and SP for differentiating mild-to-moderate and non-COPD patients (n=160): Questionnaire: 83.6%, 67.8%; PEF (≤450 L/min; ≤350 L/min): 83.6%, 66.7%; CAPTURE (Questionnaire+PEF): 71.2%, 83.9%. COPD patients whose CAPTURE results suggested that diagnostic evaluation was warranted (n=52) were more likely to be symptomatic than patients whose results did not (n=21) (mMRC >2: 37% vs 5%, p<0.01; CAT>10: 86% vs 57%, p<0.01). CAPTURE differentiated COPD from no COPD (n=346): SN: 88.0%, SP: 83.9%.

Conclusion

CAPTURE (450/350) may be useful for identifying symptomatic patients with mild-to-moderate airflow obstruction in need of diagnostic evaluation for COPD.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2018

Publication date (Electronic): 13 June 2018

Volume: 13

Pages: 1901-1912

Affiliations

[1 ]Evidera, Patient-Centered Research, Bethesda, MD, USA

[2 ]Weill Cornell Medicine, Joan & Sanford Weill Department of Medicine, New York, NY, USA

[3 ]University of Kentucky, Preventive Medicine & Environmental Health, Lexington, KY, USA

[4 ]University of Michigan, Division of Pulmonary & Critical Care Medicine, Ann Arbor, MI, USA

[5 ]Evidera, Patient-Centered Research, Seattle, WA, USA

[6 ]University of Michigan, Department of Health Behavior & Health Education, School of Public Health, Ann Arbor, MI, USA

[7 ]University of Nebraska Medical Center College of Nursing, Omaha, NE, USA

[8 ]National Jewish Health, Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, Denver, CO, USA

[9 ]Columbia University Medical Center, Division of Pulmonary, Allergy, & Critical Care, New York, NY, USA

[10 ]AstraZeneca, IMED Biotech Unit, Cambridge, UK & University of Nebraska Medical Center, Department of Medicine, Omaha, NE, USA

[11 ]University of Minnesota, Department of Family & Community Health, Minneapolis, MN & COPD Foundation, Miami, FL, USA

Author notes

Correspondence: Nancy K Leidy, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD 20814, USA, Tel [phone], Fax [phone], Email nancy.leidy@ 123456evidera.com

Article

Publisher ID: copd-13-1901

DOI: 10.2147/COPD.S152226

PMC ID: 6005334

Copyright statement: © 2018 Leidy et al. This work is published and licensed by Dove Medical Press Limited

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Categories

Subject: Original Research