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 (FEV1)/forced vital capacity (FVC)11 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: FEV1/FVC=0.60 (+0.1), FEV1% 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%, p10: 86% vs 57%, p
Conclusion: CAPTURE (450/350) may be useful for identifying symptomatic patients with mild-to-moderate airflow obstruction in need of diagnostic evaluation for COPD.
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Funding for this work was provided by the National Heart, Lung, and Blood Institute NHLBI: R01 HL114055. A portion of Dr Make’s efforts was also supported by NHLBI: R01 HL089856 and R01 HL089897.
As noted in the paper, this was a secondary analysis of data collected during the prospective, cross-sectional, multisite, case–control study used to develop CAPTURE. Methods and results of the primary paper were published in the American Journal of Respiratory and Critical Care Medicine (see the study by Martinez et al).
Leidy, Nancy K.; Martinez, Fernando J.; Malley, Karen G.; Mannino, David M.; Han, MeiLan K.; Bacci, Elizabeth D.; Brown, Randall W.; Houfek, Julia F.; Labaki, Wassim W.; Make, Barry J.; Meldrum, Catherine A.; Quezada, Wilson; Rennard, Stephen; Thomashow, Byron; and Yawn, Barbara P., "Can CAPTURE Be Used to Identify Undiagnosed Patients with Mild-To-Moderate COPD Likely to Benefit from Treatment?" (2018). Preventive Medicine and Environmental Health Faculty Publications. 51.