The COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE) tool was developed to identify patients with undiagnosed COPD with FEV1 <60% predicted or risk of exacerbation as treatment criteria. To test the ability of CAPTURE to identify patients requiring treatment because of symptoms or risk of exacerbation or hospitalization. Data were from COMPASS, a prospective study in China of COPD, chronic bronchitis without airflow limitation (post-bronchodilator FEV1/FVC >0.70), and healthy never-smokers. CAPTURE was tested as questions alone and with peak expiratory flow (PEF). Sensitivity, specificity, positive and negative predicted values (PPV and NPV) were calculated for CAT ≥10 vs <10, mMRC ≥2 vs <2, and ≥1 moderate exacerbation or hospitalization vs none in the previous year. COPD patients (n=1696), mean age 65±7.5 years, 90% males, post-bronchodilator FEV1 66.5±20.1% pred; controls (n=307), age 60.2±7.0 years, 65% males, FEV1/FVC 0.78±0.04. CAPTURE using PEF showed the best combination of sensitivity and specificity. Sensitivity and specificity to detect CAT ≥10 were 68.5% and 64.0%, respectively; mMRC ≥2 (85.6% and 61.0%), ≥1 moderate exacerbation (63.5% and 55.6%) and hospitalization (70.2% and 59.4%). PPV ranged 15.6% (moderate exacerbations) to 47.8% (CAT). NPV ranged 80.8% (CAT) to 95.6% (mMRC). CAPTURE has good sensitivity to identify COPD patients who may require treatment because of elevated symptoms, risk of exacerbations or hospitalization, including those with FEV1 >60% predicted. High NPV values show it can also exclude those who may not require treatment. GSK (208630).
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