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Identification of adults with symptoms suggestive of obstructive airways disease: Validation of a postal respiratory questionnaire

DOI: 10.1186/1471-2296-4-5

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A two-stage design was used. All adults in two practice populations were sent the questionnaire and a stratified random sample of respondents was selected to undergo full clinical evaluation. Three respiratory physicians reviewed the results of each evaluation. A majority decision was reached as to whether the subject merited a trial of obstructive airways disease medication. This clinical decision was compared with two scoring systems based on the questionnaire in order to determine their positive predictive value, sensitivity and specificity.The PPV (positive predictive value) of the first scoring system was 75.1% (95% CI 68.6–82.3), whilst that of the second system was 82.3% (95% CI 75.9–89.2). The more stringent second system had the greater specificity, 97.1% (95% CI 96.0–98.2) versus 95.3% (95% CI 94.0–96.7), but poorer sensitivity 46.9% (95% CI 33.0–66.8) versus 50.3% (95% CI 35.3–71.6).This scoring system based on the number of symptoms/risk factors reported via a postal questionnaire could be used to identify adults who would benefit from a trial of treatment for obstructive airways disease.The aim of the study was to validate two simple scoring systems for a self-completed postal questionnaire designed to identify adult patients likely to have asthma/COPD (obstructive airways disease).It has been reported that asthma is under-diagnosed and under-treated in adults [1,2]. In the short term this probably leads to increased morbidity for sufferers, and in the long term it may have a detrimental effect on their lung function and clinical state [3]. Chronic obstructive pulmonary disease is also thought to be under-diagnosed in adults [4]. This may lead to increased morbidity and the loss of an effective opportunity for giving smoking cessation advice. There may be clinical benefits to the individual and health economic benefits to society from identifying and treating patients who have asthma or COPD and who are unknown to the medical services. Before this hypot


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