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Development of the Lung Function Questionnaire (LFQ) to identify airflow obstruction.

Author information

1
Olmsted Medical Center, Department of Research, Rochester, MN, USA. yawnx002@umn.edu

Abstract

OBJECTIVE:

To describe the item-selection and item-reduction for the Lung Function Questionnaire (LFQ), being developed to help clinicians identify patients appropriate for diagnostic evaluation for chronic obstructive pulmonary disease (COPD) using spirometry.

METHODS:

Item selection and reduction were based on information from 387 > or =40-year-old respondents to the third National Health and Nutrition Examination Survey who had self-reported chronic bronchitis. Item reduction involved stepwise logistic regression. The accuracy of the final subset of items for identifying individuals with airflow obstruction (forced expiratory volume in one second/forced vital capacity <0.70) versus those without it was assessed with receiver operating characteristic analysis. Content and face validity were assessed using focus groups of primary care physicians (n = 16) and interviews with COPD patients (n = 16).

RESULTS:

The model with all five items (age; smoking history; the presence of wheeze, dyspnea, and phlegm) compared with models with combinations of fewer items had the highest classification accuracy (area under the curve [AUC] = 0.720) with sensitivity and specificity of 73.2% and 58.2%, respectively. The presence of three or more factors yielded the highest AUC, a result suggesting that three or more affirmative answers is the most appropriate criterion indicating presence of airflow obstruction.

CONCLUSIONS:

The five-item LFQ retained sufficient accuracy, sensitivity, and specificity in identifying individuals with COPD for further validation testing.

KEYWORDS:

chronic bronchitis; chronic obstructive pulmonary disease; diagnosis; respiratory disease; screening; spirometry

PMID:
20368906
PMCID:
PMC2846155
[Indexed for MEDLINE]
Free PMC Article
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