Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group

Introduction The latest chronic obstructive pulmonary disease (COPD) epidemiology survey in China estimated that there were 99 million potential COPD patients in the country, the majority of whom are undiagnosed. Screening for COPD in primary care settings is of vital importance for China, but it is...

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Main Authors: Sue Jowett, Peymane Adab, Chunhua Chi, Alice J Sitch, Andrew P Dickens, Alexandra Enocson, Zihan Pan, Xia Kong, Kar Keung Cheng, Rachel Jordan
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e035738.full
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author Sue Jowett
Peymane Adab
Chunhua Chi
Alice J Sitch
Andrew P Dickens
Alexandra Enocson
Zihan Pan
Xia Kong
Kar Keung Cheng
Rachel Jordan
author_facet Sue Jowett
Peymane Adab
Chunhua Chi
Alice J Sitch
Andrew P Dickens
Alexandra Enocson
Zihan Pan
Xia Kong
Kar Keung Cheng
Rachel Jordan
author_sort Sue Jowett
collection DOAJ
description Introduction The latest chronic obstructive pulmonary disease (COPD) epidemiology survey in China estimated that there were 99 million potential COPD patients in the country, the majority of whom are undiagnosed. Screening for COPD in primary care settings is of vital importance for China, but it is not known which strategy would be the most suitable for adoption in primary care. Studies have been conducted to test the accuracy of questionnaires, expiratory peak flow meters and microspirometers to screen for COPD, but no study has directly evaluated and compared the effectiveness and cost-effectiveness of these methods in the Chinese setting.Methods and analysis We present the protocol for a multicentre cross-sectional study, to be conducted in eight community hospitals from four cities among Chinese adults aged 40 years or older to investigate the effectiveness and cost-effectiveness of different case-finding methods for COPD, and determine the test performance of individual and combinations of screening tests and strategies in comparison with quality diagnostic spirometry. Index tests are screening questionnaires (COPD Diagnostic Questionnaire (CDQ), COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk Questionnaire (CAPTURE), symptom-based questionnaire, COPD Screening Questionnaire (COPD-SQ)), microspirometer and peak flow. Each participant will complete all of these tests in one assessment. The primary analysis will compare the performance of a screening questionnaire with a handheld device. Secondary analyses will include the comparative performance of each index test, as well as a comparison of strategies where we use a screening questionnaire and a handheld device. Approximately 2000 participants will be recruited over 9 to 12 months.Ethics and dissemination The study has been approved by Peking University Hospital and University of Birmingham. All study participants will provide written informed consent. Study results will be published in appropriate journal and presented at national and international conferences, as well as relevant social media and various community/stakeholder engagement activities.Trial registration number ISRCTN13357135.
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spelling doaj-art-f905c8e28d7c4ee0b963844d35b276a32024-11-27T18:15:07ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2019-035738Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well groupSue Jowett0Peymane Adab1Chunhua Chi2Alice J Sitch3Andrew P Dickens4Alexandra Enocson5Zihan Pan6Xia Kong7Kar Keung Cheng8Rachel Jordan9professor of health economicsInstitute of Applied Health Research, University of Birmingham, Birmingham, UKGeneral Practice Department, Peking University First Hospital, Beijing, People`s Republic of ChinaNIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UKInstitute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKInstitute of Applied Health Research, University of Birmingham, Birmingham, UKPulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, ChinaDepartment of General Practice, Peking University First Hospital, Beijing, ChinaInstitute of Applied Health Research, University of Birmingham, Birmingham, UKUniversity of Birmingham, UKIntroduction The latest chronic obstructive pulmonary disease (COPD) epidemiology survey in China estimated that there were 99 million potential COPD patients in the country, the majority of whom are undiagnosed. Screening for COPD in primary care settings is of vital importance for China, but it is not known which strategy would be the most suitable for adoption in primary care. Studies have been conducted to test the accuracy of questionnaires, expiratory peak flow meters and microspirometers to screen for COPD, but no study has directly evaluated and compared the effectiveness and cost-effectiveness of these methods in the Chinese setting.Methods and analysis We present the protocol for a multicentre cross-sectional study, to be conducted in eight community hospitals from four cities among Chinese adults aged 40 years or older to investigate the effectiveness and cost-effectiveness of different case-finding methods for COPD, and determine the test performance of individual and combinations of screening tests and strategies in comparison with quality diagnostic spirometry. Index tests are screening questionnaires (COPD Diagnostic Questionnaire (CDQ), COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk Questionnaire (CAPTURE), symptom-based questionnaire, COPD Screening Questionnaire (COPD-SQ)), microspirometer and peak flow. Each participant will complete all of these tests in one assessment. The primary analysis will compare the performance of a screening questionnaire with a handheld device. Secondary analyses will include the comparative performance of each index test, as well as a comparison of strategies where we use a screening questionnaire and a handheld device. Approximately 2000 participants will be recruited over 9 to 12 months.Ethics and dissemination The study has been approved by Peking University Hospital and University of Birmingham. All study participants will provide written informed consent. Study results will be published in appropriate journal and presented at national and international conferences, as well as relevant social media and various community/stakeholder engagement activities.Trial registration number ISRCTN13357135.https://bmjopen.bmj.com/content/10/11/e035738.full
spellingShingle Sue Jowett
Peymane Adab
Chunhua Chi
Alice J Sitch
Andrew P Dickens
Alexandra Enocson
Zihan Pan
Xia Kong
Kar Keung Cheng
Rachel Jordan
Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group
BMJ Open
title Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group
title_full Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group
title_fullStr Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group
title_full_unstemmed Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group
title_short Study to evaluate the effectiveness and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among residents (≥40 years) in four cities in China: protocol for a multicentre cross-sectional study on behalf of the Breathe Well group
title_sort study to evaluate the effectiveness and cost effectiveness of different screening strategies for identifying undiagnosed copd among residents ≥40 years in four cities in china protocol for a multicentre cross sectional study on behalf of the breathe well group
url https://bmjopen.bmj.com/content/10/11/e035738.full
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