| Registro completo |
| Provedor de dados: |
ArchiMer
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| País: |
France
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| Título: |
Is generalization of exhaled CO assessment in primary care helpful for early diagnosis of COPD?
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| Autores: |
Molinari, Nicolas
Abou-badra, Mathieu
Marin, Gregory
Ky, Chin-long
Amador, Noemi
Gamez, Anne Sophie
Vachier, Isabelle
Bourdin, Arnaud
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| Data: |
2015-04
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| Ano: |
2015
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| Palavras-chave: |
COPD
Screening
Exhaled CO
Smoking
Behaviour
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| Resumo: |
Background: COPD is largely under-diagnosed and once diagnosed usually at a late stage. Early diagnosis is thoroughly recommended but most attempts failed as the disease is marginally known and screening marginally accepted. It is a rare cause of concern in primary care and spirometry is not very common. Exhaled carbon monoxide (eCO) is a 5-seconds easy-to-use device dedicated to monitor cigarette smoke consumption. We aimed to assess whether systematic eCO measurement in primary care is a useful tool to improve acceptance for early COPD diagnosis. Methods: This was a two-center randomized controlled trial enrolling 410 patients between March and May, 2013. Whatever was the reason of attendance to the clinic, all adults were proposed to measure eCO during randomly chosen days and outcomes were compared between the two different groups of patients (performing and not performing eCO). Primary outcome was the rates of acceptance for COPD screening. Results: Rate of acceptance for COPD screening was 28% in the eCO group and 26% in the other (P = 0.575). These rates increased to 48 and 51% in smokers (current and former). eCO significantly increased the rate of clinics during which a debate on smoking was initiated (42 vs. 24%, P = 0.001). eCO at 2.5 ppm was the discriminative concentration for identifying active smokers (ROC curve AUC: 0.935). Smoking was the only independent risk factor associated with acceptance for early COPD screening (OR = 364.6 (82.5-901.5) and OR = 78.5 (18.7-330.0) in current and former smokers, respectively) while eCO measurement was not. Conclusions: Early COPD diagnosis is a minor cause of concern in primary care. Systematic eCO assessment failed to improve acceptance for early COPD screening.
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| Tipo: |
Text
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| Idioma: |
Inglês
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| Identificador: |
http://archimer.ifremer.fr/doc/00270/38142/36280.pdf
DOI:10.1186/s12890-015-0039-6
http://archimer.ifremer.fr/doc/00270/38142/
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| Editor: |
Biomed Central Ltd
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| Formato: |
application/pdf
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| Fonte: |
Bmc Pulmonary Medicine (1471-2466) (Biomed Central Ltd), 2015-04 , Vol. 15 , N. 44 , P. 1-7
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| Direitos: |
2015 Molinari et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise st
info:eu-repo/semantics/openAccess
restricted use
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