SESSION TITLE: COPD Poster Discussion
SESSION TYPE: Original Investigation Poster Discussion
PRESENTED ON: Sunday, October 25, 2015 at 01:30 PM - 03:00 PM
PURPOSE: Diagnosis of COPD in the community,based on clinical grounds,has been found to be insensitive,missing about half of all patients with the disease.To add,in resource-limited settings such as India,COPD is under-diagnosed due to lack of universal access to spirometry.The Vitalograph COPD-6(Vitalograph Ltd,Ireland) is a simple,inexpensive(approximate cost $100) handheld device that can be used to screen for COPD.The purpose of the study was to determine accuracy of Vitalograph COPD-6 in screening for COPD,and to test reliability of the device.
METHODS: The PD Hinduja Hospital,Mumbai is a tertiary care center that caters to the population of the city.Spirometry is offered as part of routine health check-up and when clinically indicated.Between Dec 2014-Mar 2015,consecutive subjects undergoing spirometry at the institution were offered testing with Vitalograph COPD-6.Testing was conducted by trained technicians using ATS criteria for quality control.As recommended by manufacturers of the device,FEV1/FEV6<0.8 was tested for screening of COPD.A postbronchodilator FEV1/FVC<0.7 on spirometry was used as reference(gold) standard for diagnosis of COPD.In addition,11 healthy volunteers were tested for ten consecutive days to assess repeatability of FEV1 measurements.
RESULTS: 765 subjects(715 undergoing annual health check-up)were enrolled and participated in the study.73 subjects(9.5%) had COPD on spirometry. The Vitalograph COPD-6 had a sensitivity of 88%(95% CI 78,94)with a negative predictive value of 98%(95% CI 97,99),ROC area 0.86(95% CI 0.82,0.9).Of the 9 patients with COPD who falsely tested negative on the Vitalograph COPD-6 device,2 were in GOLD stage-1, and 7 were in GOLD stage-2.Median coefficient of variation of FEV1 among 11 subjects tested daily was 2.2(IQR 1.7,2.7).
CONCLUSIONS: The Vitalograph COPD-6 is sensitive and reliable for screening of COPD,and appears to be more sensitive than similar devices such as Piko-6 and screening questionnaires.It can serve as a valuable point-of-care screening tool,especially in resource-limited settings.
CLINICAL IMPLICATIONS: Using the Vitalograph COPD-6 device to screen for COPD in the community could lead to an earlier diagnosis of the disease,thereby leading to interventions that could improve quality of life of individuals with COPD and alter the course of the disease. Acknowledgement:The study was funded by “Project Québec-Maharashtra,Relations internationales et de la Francophonie,Quebec”.We thank Cipla Respiratory for providing us with Vitalograph COPD-6 device.
DISCLOSURE: The following authors have nothing to disclose: Radhika Banka, Sharmila Lonkar, Mangal Walkar, Getsiyal Pabidha, Matthew Shorofsky, Jean Bourbeau, Lancelot Pinto
No Product/Research Disclosure Information