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Observational Study
. 2021 Jun 17:16:1771-1782.
doi: 10.2147/COPD.S302259. eCollection 2021.

Utility of Self-Administered Questionnaires for Identifying Individuals at Risk of COPD in Japan: The OCEAN (Okinawa COPD casE finding AssessmeNt) Study

Kentaro Tamaki  1 , Eishin Sakihara  2 , Hiroaki Miyata  3 , Norimichi Hirahara  3 , Oksana Kirichek  4 , Ryosuke Tawara  5 , Shoko Akiyama  5 , Masayuki Katsumata  5 , Mei Haruya  6 , Takeo Ishii  7 , Edgar P Simard  8 , Bruce E Miller  8 , Ruth Tal-Singer  8 , Toshihiko Kaise  5
Affiliations
Observational Study

Utility of Self-Administered Questionnaires for Identifying Individuals at Risk of COPD in Japan: The OCEAN (Okinawa COPD casE finding AssessmeNt) Study

Kentaro Tamaki et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: A considerable proportion of patients with chronic obstructive pulmonary disease (COPD) remain undiagnosed and untreated even though they may have a burden of respiratory symptoms that impact quality of life. The OCEAN study assessed the ability of screening questionnaires to identify individuals with, or at risk of, COPD by comparing questionnaire outcomes with spirometric measures of lung function.

Methods: This observational study included participants ≥40 years of age presenting for their annual health examination at a single medical center in Okinawa, Japan. Participants completed COPD screening questionnaires (CAPTURE and COPD-Q), the Chronic Airways Assessment Test (CAAT), and general demographic and health-related questionnaires. The performance characteristics of CAPTURE and COPD-Q were compared with spirometry-based airflow limitation by calculating the area under the receiver operating characteristic (ROC-AUC) curve.

Results: A total of 2518 participants were included in the study; 79% of whom were <60 years of age (mean 52.0 years). A total of 52 (2.1%) participants had airflow limitation defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7, and 420 (16.7%) participants were classified as Preserved Ratio Impaired Spirometry (PRISm). Among participants with PRISm, 75 (17.9%) had a CAAT total score ≥10. Airflow limitation and PRISm were more prevalent in current smokers versus past smokers. For the CAPTURE questionnaire, ROC-AUC for screening airflow limitation, PRISm, and PRISm with a CAAT total score ≥10 were 0.59, 0.55, and 0.69, respectively; for COPD-Q, these three clinical features were 0.67, 0.58 and 0.68, respectively.

Conclusion: This study demonstrated that CAPTURE and COPD-Q appear to be effective screening tools for identifying symptomatic individuals with undiagnosed, or at risk of developing COPD in adults ≥40 years of age in Okinawa. Furthermore, early diagnosis and management of PRISm is important to improve future outcomes and the societal burden of disease.

Keywords: CAAT; CAPTURE; COPD; COPD-Q; Japan; PRISm.

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Conflict of interest statement

Kentaro Tamaki, Eishin Sakihara, Hiroaki Miyata, and Norimichi Hirahara belong to the association/institution that received funding for this study from GSK. Takeo Ishii, Shoko Akiyama, Toshihiko Kaise, Masayuki Katsumata and Ryosuke Tawara are employees of GSK and hold shares in GSK. Mei Haruya, Oksana Kirichek and Edgar P. Simard are former employees of GSK. Bruce E. Miller and Ruth Tal-Singer are former employees of GSK and hold shares in GSK. Ruth Tal-Singer reports personal fees from Ena Respiratory, Immunomet, Vocalis Health, and Teva. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
ROC curve from logistic regression models for airflow limitation, PRISm, and PRISm/CAAT score ≥10 by CAPTURE and COPD-Q total score.
Figure 2
Figure 2
Performance properties of CAPTURE (A) and COPD-Q total score (B). *Accuracy calculated as true positives and true negatives divided by the total number of responses.
See this image and copyright information in PMC

Comment in

  • Letter to Editor Regarding the OCEAN Study [Letter].
    Yawn BP, Make B, Mannino D, Martinez FJ, Han MK. Yawn BP, et al. Int J Chron Obstruct Pulmon Dis. 2021 Sep 2;16:2501-2502. doi: 10.2147/COPD.S332598. eCollection 2021. Int J Chron Obstruct Pulmon Dis. 2021. PMID: 34511894 Free PMC article. No abstract available.

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