Yield 63 percent sensitivity, 88 percent specificity for COPD in current, former heavy smokers
TUESDAY, Oct. 25 (HealthDay News) -- Low-dose inspiratory and expiratory lung cancer screening computed tomography (CT) scans can be used to identify chronic obstructive pulmonary disease (COPD), according to a study published in the Oct. 26 issue of the Journal of the American Medical Association.
Onno M. Mets, M.D., from the University Medical Center Utrecht in the Netherlands, and colleagues investigated whether low-dose CT-based lung cancer screening could help identify COPD in 1,140 current and former male smokers. Participants underwent prebronchodilator pulmonary function testing with inspiratory and expiratory CT on the same day between July 2007 and September 2008. A diagnostic prediction model for airflow limitation was developed and the accuracy of COPD diagnosis was assessed, using pulmonary function tests as the reference standard.
The investigators found that lung function testing identified 437 participants with COPD. Using a diagnostic model corrected for overoptimism, with CT emphysema, CT air trapping, body mass index, pack-years, and smoking status, the area under the receiver operating characteristic curve was 0.83. At the point of optimal accuracy, 274 cases of COPD were identified, with 85 false-positives. The sensitivity was 63 percent, specificity was 88 percent, positive predictive value was 76 percent, and negative predictive value was 79 percent. Using the model, the area under the receiver operating characteristic curve was 0.87 and 0.78 for participants with and without symptoms, respectively.
"Quantitative measures in low-dose CT scans may be useful in a lung cancer screening setting to identify heavy smokers with COPD," the authors write.
Abstract
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