ArticleNPJ primary care respiratory medicine2022
Accuracy and economic evaluation of screening tests for undiagnosed COPD among hypertensive individuals in Brazil.
Article in NPJ primary care respiratory medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 4 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 4 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Prevalence of COPD in other long-term conditions: a systematic meta review.BMC pulmonary medicine · 2026Pooled it
- Economic evaluations of screening and case-finding for Chronic Obstructive Pulmonary Disease (COPD): a systematic review.NPJ primary care respiratory medicine · 2026Pooled it
- Cost-effectiveness of screening for chronic obstructive pulmonary disease: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Prevalence of chronic respiratory disease using case-finding tools in adults living with noncommunicable disease in low- and middle-income countries: a systematic review.BMC pulmonary medicine · 2025Pooled it
- Is primary care the 'right care' for respiratory medicine in Africa?African journal of primary health care & family medicine · 2026Article
- Predictive performance of the PUMA questionnaire as an opportunistic COPD case-finding tool in Singapore primary care.NPJ primary care respiratory medicine · 2026Observational
- Mitigating chronic respiratory disease through the lens of multimorbidity: the MARES mixed-methods study protocol.BMJ open · 2026Article
- Predictors of health-related quality of life among rural adult residents of western Maharashtra, India.Frontiers in public health · 2026Article
- A Two-Staged, Risk-Stratified Strategy Combining FEVRespirology (Carlton, Vic.) · 2025Observational
- Living with COPD and its psychological effects on participating in community-based physical activity in Brazil: a qualitative study. Findings from the Breathe Well group.NPJ primary care respiratory medicine · 2024Article
- Engaging stakeholders to level up COPD care in LMICs: lessons learned from the "Breathe Well" programme in Brazil, China, Georgia, and North Macedonia.BMC health services research · 2024Article
- Strengthening Clinician-Researchers' Communication and Knowledge Translation Skills: An Innovative Game Model From the Breathe Well Group.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
24 authors at 11 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In Brazil, prevalence of diagnosed COPD among adults aged 40 years and over is 16% although over 70% of cases remain undiagnosed. Hypertension is common and well-recorded in primary care, and frequently co-exists with COPD because of common causes such as tobacco smoking, therefore we conducted a cross-sectional screening test accuracy study in nine Basic Health Units in Brazil, among hypertensive patients aged ≥40 years to identify the optimum screening test/combinations to detect undiagnosed COPD. We compared six index tests (four screening questionnaires, microspirometer and peak flow) against the reference test defined as those below the lower limit of normal (LLN-GLI) on quality diagnostic spirometry, with confirmed COPD at clinical review. Of 1162 participants, 6.8% (n = 79) had clinically confirmed COPD. Peak flow had a higher specificity but lower sensitivity than microspirometry (sensitivity 44.3% [95% CI 33.1, 55.9], specificity 95.5% [95% CI 94.1, 96.6]). SBQ performed well compared to the other questionnaires (sensitivity 75.9% [95% CI 65.0, 84.9], specificity 59.2% [95% CI 56.2, 62.1]). A strategy requiring both SBQ and peak flow to be positive yielded sensitivity of 39.2% (95% CI 28.4, 50.9) and specificity of 97.0% (95% CI 95.7, 97.9). The use of simple screening tests was feasible within the Brazilian primary care setting. The combination of SBQ and peak flow appeared most efficient, when considering performance of the test, cost and ease of use (costing £1690 (5554 R$) with 26.7 cases detected per 1,000 patients). However, the choice of screening tests depends on the clinical setting and availability of resources.ISRCTN registration number: 11377960.
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