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Respirology. 2015 May;20(4):626-32. doi: 10.1111/resp.12511. Epub 2015 Mar 30.

New scoring system for the differentiation of chronic obstructive pulmonary disease and asthma.

Author information

1
Division of Pulmonary Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea; Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.

Abstract

BACKGROUND AND OBJECTIVE:

It remains difficult to differentiate between chronic obstructive pulmonary disease (COPD) and asthma in clinical practice, especially in a primary care setting. The purpose of this study was to develop a new scoring system for differentiating between COPD and asthma, and to evaluate its effectiveness.

METHODS:

First, to identify important variables differentiating COPD from asthma, the data of 197 patients with COPD and 138 patients with asthma were assessed retrospectively. Secondly, a scoring system that was based on these variables was then developed, and its performance was internally validated using a bootstrapping-based method. Thirdly, the scoring system was externally validated using prospectively collected data from patients with COPD (n = 104) or asthma (n = 96).

RESULTS:

The final scoring system was composed of the four variables: age of onset of breathlessness (<40 years, 0 points; 40-60 years, 2 points; >60 years, 4 points), continuous breathlessness (no, 0 points; yes, 1 point), diurnal variation of breathlessness (yes, 0 points; no, 1 point) and emphysematous change in chest X-ray (no, 0 points; yes, 1 point). The patients were classified by their total score into three categories: 0-2 points, probable asthma; 3-4 points, difficult-to-differentiate; 5-7 points, probable COPD. The new scoring system performed well in the external validation dataset (area under the curve, 0.86; 95% confidence interval: 0.813-0.911; P < 0.001).

CONCLUSIONS:

The new scoring system that was developed in this study may be a useful tool for differentiating between COPD and asthma in primary care.

KEYWORDS:

asthma; chronic obstructive pulmonary disease; differential diagnosis; primary care physician

PMID:
25823440
DOI:
10.1111/resp.12511
[Indexed for MEDLINE]
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