Concordance between clinical diagnosis and a questionnaire based on symptoms to assess the diagnostic possibility of COPD in colombian patients

Concordancia entre el diagnóstico clínico y un cuestionario basado en síntomas para establecer la posibilidad diagnóstica de EPOC en pacientes colombianos

Introduction: Questionnaires based on symptoms can be useful for screening patients with COPD within the general population, or as a tool for differential diagnosis that can facilitate early initiation of therapy in places where spirometry is not available.

Methodology: In a pilot study, 105 Colombian specialized physicians and general practitioners applied an 8-question questionnaire to 778 of their patients, who had been previously diagnosed with COPD. It was not taken into consideration whether the patients were or were not receiving drug therapy for COPD at the moment of answering the questionnaire.

Results: The scores allowed classification of the patients into three risk categories: 1. Low risk (117 patients); 2. Moderate risk (125 patients); and 3. High risk (536 patients). The average score was 22,5 (SD: 5,57). These results suggest that the instrument’s sensitivity is 68,9%, and that the questionnaire did not detect 31,1% of the patients as having COPD. All questionnaires were correctly filled out, and no conditions besides those of an ordinary medical consultation were required.

Conclusions: The questionnaire assessed in this study showed scarce diagnostic correlation with the clinical expertise of the attending physician. In order to assess all the diagnostic properties of this questionnaire or of its modifications, spirometry is required as the golden standard for the diagnosis of COPD. The use of brief diagnostic questionnaires within the frame of ordinary medical consultation is logistically possible and does not demand additional resources or time