Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q)
Background: The considerable prevalence and worse outcomes of asthma-COPD overlap (ACO) in COPD have been reported, and optimal introduction of ICS is essential for ACO. However, diagnostic criteria for ACO consist of multiple laboratory tests, which is challenging during this COVID-19 era. The purp...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Allergology International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893023000059 |
| _version_ | 1797795275877646336 |
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| author | Yuki Suzuki Hiroyuki Nagase Hikaru Toyota Sho Ohyatsu Konomi Kobayashi Yuri Takeshita Yuuki Uehara Saya Hattori Mana Ishizuka Hirokazu Sakasegawa Michio Kuramochi Tadashi Kohyama Naoya Sugimoto |
| author_facet | Yuki Suzuki Hiroyuki Nagase Hikaru Toyota Sho Ohyatsu Konomi Kobayashi Yuri Takeshita Yuuki Uehara Saya Hattori Mana Ishizuka Hirokazu Sakasegawa Michio Kuramochi Tadashi Kohyama Naoya Sugimoto |
| author_sort | Yuki Suzuki |
| collection | DOAJ |
| description | Background: The considerable prevalence and worse outcomes of asthma-COPD overlap (ACO) in COPD have been reported, and optimal introduction of ICS is essential for ACO. However, diagnostic criteria for ACO consist of multiple laboratory tests, which is challenging during this COVID-19 era. The purpose of this study was to create a simple questionnaire to diagnose ACO in patients with COPD. Methods: Among 100 COPD patients, 53 were diagnosed with ACO based on the Japanese Respiratory Society Guidelines for ACO. Firstly, 10 candidate questionnaire items were generated and further selected by a logistic regression model. An integer-based scoring system was generated based on the scaled estimates of items. Results: Five items, namely a history of asthma, wheezing, dyspnea at rest, nocturnal awakening, and weather- or season-dependent symptoms, contributed significantly to the diagnosis of ACO in COPD. History of asthma was related to FeNO >35 ppb. Two points were assigned to history of asthma and 1 point to other items in the ACO screening questionnaire (ACO-Q), and the area under the receiver operating characteristic curve was 0.883 (95% CI: 0.806–0.933). The best cutoff point was 1 point, and the positive predictive value was 100% at a cutoff of 3 points or higher. The result was reproducible in the validation cohort of 53 patients with COPD. Conclusions: A simple questionnaire, ACO-Q, was developed. Patients with scores ≥3 could be reasonably recommended to be treated as ACO, and additional laboratory testing would be recommended for patients with 1 and 2 points. |
| first_indexed | 2024-03-13T03:15:29Z |
| format | Article |
| id | doaj.art-dba84fd8f7e74111971958f2572e5245 |
| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-03-13T03:15:29Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-dba84fd8f7e74111971958f2572e52452023-06-26T04:13:38ZengElsevierAllergology International1323-89302023-07-01723394401Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q)Yuki Suzuki0Hiroyuki Nagase1Hikaru Toyota2Sho Ohyatsu3Konomi Kobayashi4Yuri Takeshita5Yuuki Uehara6Saya Hattori7Mana Ishizuka8Hirokazu Sakasegawa9Michio Kuramochi10Tadashi Kohyama11Naoya Sugimoto12Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan; Corresponding author. Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo 173-8605, Japan.Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDepartment of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanDepartment of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, JapanDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, JapanBackground: The considerable prevalence and worse outcomes of asthma-COPD overlap (ACO) in COPD have been reported, and optimal introduction of ICS is essential for ACO. However, diagnostic criteria for ACO consist of multiple laboratory tests, which is challenging during this COVID-19 era. The purpose of this study was to create a simple questionnaire to diagnose ACO in patients with COPD. Methods: Among 100 COPD patients, 53 were diagnosed with ACO based on the Japanese Respiratory Society Guidelines for ACO. Firstly, 10 candidate questionnaire items were generated and further selected by a logistic regression model. An integer-based scoring system was generated based on the scaled estimates of items. Results: Five items, namely a history of asthma, wheezing, dyspnea at rest, nocturnal awakening, and weather- or season-dependent symptoms, contributed significantly to the diagnosis of ACO in COPD. History of asthma was related to FeNO >35 ppb. Two points were assigned to history of asthma and 1 point to other items in the ACO screening questionnaire (ACO-Q), and the area under the receiver operating characteristic curve was 0.883 (95% CI: 0.806–0.933). The best cutoff point was 1 point, and the positive predictive value was 100% at a cutoff of 3 points or higher. The result was reproducible in the validation cohort of 53 patients with COPD. Conclusions: A simple questionnaire, ACO-Q, was developed. Patients with scores ≥3 could be reasonably recommended to be treated as ACO, and additional laboratory testing would be recommended for patients with 1 and 2 points.http://www.sciencedirect.com/science/article/pii/S1323893023000059AsthmaAsthma-COPD overlapCOPDFeNOQuestionnaire |
| spellingShingle | Yuki Suzuki Hiroyuki Nagase Hikaru Toyota Sho Ohyatsu Konomi Kobayashi Yuri Takeshita Yuuki Uehara Saya Hattori Mana Ishizuka Hirokazu Sakasegawa Michio Kuramochi Tadashi Kohyama Naoya Sugimoto Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q) Allergology International Asthma Asthma-COPD overlap COPD FeNO Questionnaire |
| title | Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q) |
| title_full | Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q) |
| title_fullStr | Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q) |
| title_full_unstemmed | Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q) |
| title_short | Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q) |
| title_sort | questionnaire for diagnosing asthma copd overlap in copd development of aco screening questionnaire aco q |
| topic | Asthma Asthma-COPD overlap COPD FeNO Questionnaire |
| url | http://www.sciencedirect.com/science/article/pii/S1323893023000059 |
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