CT scans to detect early COPD

January 01, 0001

CT scans to detect early COPD

CT scans of the chest will sometimes identify findings suggestive of COPD in patients who don’t bear that diagnosis. These Dutch researchers wanted to see whether whether low-dose lung cancer screening CT scans can accurately identify participants with COPD. They performed a prospective cross- sectional study as part of a larger lung cancer screening trial. Pulmonary function testing and inspiratory and expiratory CT scans of the chest were obtained in malesn (n=1140). Logistic regression aided in developing a diagnostic prediction model.

The researchers found: "Four hundred thirty-seven participants (38%) had COPD according to lung function testing. A diagnostic model with CT emphysema, CT air trapping, body mass index, pack-years, and smoking status corrected for overoptimism (internal validation) yielded an area under the receiver operating characteristic curve of 0.83. Using the point of optimal accuracy, the model identified 274 participants with COPD with 85 false- positives, a sensitivity of 63%, specificity of 88%, positive predictive value of 76%, and negative predictive value of 79%. The diagnostic model showed an area under the receiver operating characteristic curve of 0.87 for participants with symptoms and 0.78 for those without symptoms."

The researchers concluded: "Among men who are current and former heavy smokers, low-dose inspiratory and expiratory CT scans obtained for lung cancer screening can identify participants with COPD, with a sensitivity of 63% and a specificity of 88%."

This study provides important information regarding the accuracy of CT studies in identifying COPD in smokers

For the full abstract, click here.

JAMA 306(16):1775-1781, 26 October 2011 © 2011 American Medical Association
Identification of Chronic Obstructive Pulmonary Disease in Lung Cancer Screening Computed Tomographic Scans. Onno M. Mets, Constantinus F. M. Buckens, Pieter Zanen, et al.

Category: R. Respiratory. Keywords: COPD, screening, computerized tomography, emphysema, smokers, prospective cross-sectional study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 8 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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