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

Kentaro Tamaki; Eishin Sakihara; Hiroaki Miyata; Norimichi Hirahara; Oksana Kirichek; Ryosuke Tawara; Shoko Akiyama; Masayuki Katsumata; Mei Haruya; Takeo Ishii; Edgar P Simard; Bruce E Miller; Ruth Tal-Singer; Toshihiko Kaise

doi:10.2147/COPD.S302259

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

Int J Chron Obstruct Pulmon Dis. 2021 Jun 17:16:1771-1782. doi: 10.2147/COPD.S302259. eCollection 2021.

Authors

Affiliations

¹ Department of Breast Surgery, Nahanishi Clinic, Okinawa, Japan.
² Lifestyle Related Disease Medical Center, Naha Medical Association, Okinawa, Japan.
³ Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.
⁴ Value Evidence and Outcomes, GSK, Stockley Park, UK.
⁵ Japan Development, GSK, Tokyo, Japan.
⁶ Government Affairs and Market Access, GSK, Tokyo, Japan.
⁷ Medical Japan, GSK, Tokyo, Japan.
⁸ Value Evidence and Outcomes, GSK, Collegeville, PA, USA.

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.

Publication types

Observational Study

MeSH terms

Adult
Forced Expiratory Volume
Humans
Japan / epidemiology
Middle Aged
Pulmonary Disease, Chronic Obstructive* / diagnosis
Pulmonary Disease, Chronic Obstructive* / epidemiology
Quality of Life*
Spirometry
Surveys and Questionnaires
Vital Capacity

Grants and funding

This study was funded by GSK (Study HO-18-19229/209243). The funders of the study had a role in study design, data analysis, data interpretation, and writing of the report.