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Prospective development of practical screening strategies for diagnosis of asthma–COPD overlap
Author(s) -
Zhou Aiyuan,
Luo Lijuan,
Liu Nian,
Zhang Cheng,
Chen Yahong,
Yin Yan,
Zhang Jing,
He Zhiyi,
Xie Lihua,
Xie Jungang,
Li Jinhua,
Zhou Zijing,
Chen Yan,
Chen Ping
Publication year - 2020
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13743
Subject(s) - medicine , pulmonologists , asthma , gold standard (test) , receiver operating characteristic , grading (engineering) , copd , intensive care medicine , civil engineering , engineering
Background and objective ACO is a syndrome with high prevalence. However, a pragmatic diagnostic criterion to differentiate ACO is non‐existent. We aimed to establish an effective model for screening ACO. Methods A multicentre survey was developed to assess the clinical criteria considered important and applicable by pulmonologists for screening ACO. These experts were asked to take the surveys twice. The expert grading method, analytic hierarchy process and ROC curve were used to establish the model, which was then validated by a cross‐sectional study of 1066 patients. The GINA/GOLD document was the gold standard in assessing this model. Results Increased variability of symptoms, paroxysmal wheezing, dyspnoea, historical diagnosis of COPD or asthma, allergic constitution, exposure to risk factors, the FEV 1 /FVC < 70% and a positive BDT were important for screening ACO. According to the weight of each criterion, we confirmed that patients meeting six or more of these eight criteria should be considered to have ACO. We called this Chinese screening model for ACO ‘CSMA’. It differentiated patients with ACO with a sensitivity of 83.33%, while the sensitivity of clinician‐driven diagnosis had a sensitivity of only 42.73%. Conclusion CSMA is a workable model for screening ACO and provides a simple tool for clinicians to efficiently diagnose ACO.