Daily Dose: COPD Diagnosis in Primary Care

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On February 15, 2023, we reported on a study published in JAMA that evaluated the operating characteristics of the CAPTURE (COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk) screening tool for identifying US primary care patients with undiagnosed, clinically significant chronic obstructive pulmonary disease (COPD).

The study

A cross-sectional study that included 4679 primary care patients aged 45-80 years without a prior COPD diagnosis. CAPTURE uses 5 symptom and exposure questions and, for a subset of patients, peak expiratory flow rates (PEFR), to detect patients with undiagnosed COPD who are candidates for immediate therapy, labeled as having clinically significant COPD. The screening generates a score that determines if a patient should undergo additional testing and clinical evaluation.

Of the 110 patients (2.5%) with undiagnosed, clinically significant COPD, 53 had a positive screening result with a sensitivity of 48.2% (95% CI, 38.6%-57.9%) and a specificity of 88.6% (95% CI, 87.6%-89.6%). CAPTURE provided false positives for 479 participants (11%) who did not have COPD.

Note from authors

"Within this US primary care population, the CAPTURE screening tool had a low sensitivity but a high specificity for identifying clinically significant COPD defined by presence of airflow obstruction that is of moderate severity or accompanied by a history of acute respiratory illness. Further research is needed to optimize performance of the screening tool and to understand whether its use affects clinical outcomes."

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