Utilidad del miniespirómetro COPD-6 en el diagnóstico precoz de EPOC

Abstract

IntroductionEarly diagnosis and treatment of chronic obstructive pulmonary disease (COPD) helps slow progression and reduce complications. The COPD-6 portable spirometer is a tool that may be useful for screening for this disease. ObjectiveTo evaluate the usefulness of the COPD-6 portable spirometer for COPD screening. MethodsWe performed a systematic review of studies evaluating the diagnostic capacity of COPD-6 in the early diagnosis of COPD. Several databases were reviewed, and the quality of the studies included was evaluated with the QUADAS-2 tool. The ROC curve and a weighted estimate of the diagnostic OR were conducted with a bivariate random effects analysis. Possible sources of heterogeneity were explored using subgroup analysis and bivariate meta-regression. ResultsFourteen studies were retrieved (3,986 patients). Statistical heterogeneity in the calculation of sensitivity and specificity was high, with acceptable overall estimates of sensitivity (0.65 [95% CI 0.63-0.68]) and specificity (0.80 [95% CI 0.78-0.81]). The area under the ROC curve was 0.90 and a threshold effect was seen. There were no significant differences in the subgroup analysis (studies conducted in Europe vs Asia, better vs poorer quality studies, and studies initially aimed at diagnosing COPD vs. those aimed at diagnosing an obstructive pattern). The ability of studies using a cut-off>0.75 to screen for COPD (high sensitivity, lower specificity) was acceptable. ConclusionCOPD-6 is a useful test for the early diagnosis of COPD patients.