How to screen chronic obstructive pulmonary disease in general practice?

The early diagnosis of chronic obstructive pulmonary disease (COPD) is prioritary. Respiratory Health Screening Questionnaire (RHSQ), validated for COPD screening, seems a simple tool in general practice. An awareness campaign on World COPD Day invited those over 40 years old, with no known respiratory diseases, to answer a questionnaire and perform a spirometry. We aimed to determine the prevalence of COPD risk factors, respiratory symptoms, comorbidities and COPD; to investigate the RHSQ validity to screen COPD. The sample included 193 participants (53% women, mean age 60+-11 years, mean BMI 27+-4kg/m2), 19% smokers and 24% former smokers (mean pack-year 20+-18). COPD risk factors and comorbidities are shown in [table 1] . Dyspnea was present in half of the subjects. Respiratory symptoms are shown in [table 2] . A positive RHSQ for possible COPD (>16 points) was obtained in 50%. COPD was diagnosed in 19 (10%) patients, mainly group A (n=11) and group B (n=6). COPD prevalence was 20% in smokers. Among COPD subjects, 16 (87%) had a positive RHSQ. The sensitivity and specificity of the RHSQ for COPD diagnosis were 90% and 45%, respectively, with a negative predictive value of 95%. Underdiagnosis of COPD is a well-known problem. The RHSQ had a high negative predictive value and may constitute a simple and cost-effective screening tool for the early diagnosis of COPD.