The predicve value of handheld peak expiratory flow metre and IPAG quesonnaire as a screening tool for COPD among high-risk paents

Abstract

Introduction: Chronic Obstrucve pulmonary Disease (COPD) is increasing in Africa due to mulple risk factors like smoking and use of biomass fuels'. There are challenges in the diagnosis of COPD at primary care due to scarcity of spirometers.
Aim: The objecve of the study was to evaluate the predicve value of peak flow rate obtained from a hand-held PEFM and quesonnaire as a screening tool of COPD among high risk paents.

Methodology: A cross-seconal study was carried out from August to November 2018. One hundred and Ninety (190) parcipants with risk factors for COPD were recruited at the Family Medicine Department in LASUTH, Lagos State. The history of risk factors, Internaonal primary airway group (IPAG) quesonnaire scores, Peak Expiratory Flow Rate (PEFR) and Spirometry values captured. The best cut-off for PEFM as a screening tool was assessed using ROC curve.

Results: PEFM had a Sensivity of 82.3%, Specificity of 51.1%, and PPV of 63.2% and NPV of 73.8%. The IPAG quesonnaire reported sensivity (44.8%) and specificity (23.4%) indicang poor detecon rates of COPD when used as a screening tool. Combining the use of a quesonnaire and peak flow meter, less than half (43.8%) of those with COPD would be idenfied. .ROC revealed best cut off for PEFR as 79.5% of expected which would give a sensivity of 81.3% and specificity of 57.7%.

Conclusion: The mechanical handheld PEFM was determined to have a high sensivity and PPV, with moderate NPV making it a useful tool in screening for COPD especially in primary care sengs where spirometry may not be available.