Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: COPD Diagnostic Questionnaire (CDQ) for selecting at-risk patients for spirometry: a cross-sectional study in Australian general practice
Author: Stanley, A.
Hasan, I.
Crockett, A.
Van Schayck, O.
Zwar, N.
Citation: npj Primary Care Respiratory Medicine, 2014; 24(1):14024-1-14024-5
Publisher: Macmillan publishers
Issue Date: 2014
ISSN: 2055-1010
Statement of
Anthony J Stanley, Iqbal Hasan, Alan J Crockett, Onno C P van Schayck & Nicholas A Zwar
Abstract: BACKGROUND: Using the COPD Diagnostic Questionnaire (CDQ) as a selection tool for spirometry could potentially improve the efficiency and accuracy of chronic obstructive pulmonary disease (COPD) diagnosis in at-risk patients. AIM: To identify an optimal single cut point for the CDQ that divides primary care patients into low or high likelihood of COPD, with the latter group undergoing spirometry. METHODS: Former or current smokers aged 40-85 years with no prior COPD diagnosis were invited to a case-finding appointment with the practice nurse at various general practices in Sydney, Australia. The CDQ was collected and pre- and post-bronchodilator spirometry was performed. Cases with complete CDQ data and spirometry meeting quality standards were analysed (1,054 out of 1,631 patients). CDQ cut points were selected from a receiver operating characteristic (ROC) curve. RESULTS: The area under the ROC curve was 0.713. A cut point of 19.5 had the optimal combination of sensitivity (63%) and specificity (70%) with two-thirds below this cut point. A cut point of 14.5 corresponded to a sensitivity of 91%, specificity of 35% and negative predictive value of 96%, and 31% of patients below this cut point. CONCLUSIONS: The CDQ can be used to select patients at risk of COPD for spirometry using one cut point. We consider two possible cut points. The 19.5 cut point excludes a higher proportion of patients from undergoing spirometry with the trade-off of more false negatives. The 14.5 cut point has a high sensitivity and negative predictive value, includes more potential COPD cases but has a higher rate of false positives.
Keywords: Pulmonary Disease, Chronic Obstructive
Sensitivity and Specificity
Aged, 80 and over
Middle Aged
Cross-Sectional Studies
Risk Factors
Rights: © 2014 Primary Care Respiratory Society UK/Macmillan Publishers This work is licensed under a Creative Commons Attribution- NonCommercial-ShareAlike 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. to view a copy of this license, visit http://
DOI: 10.1038/npjpcrm.2014.24
Grant ID:
Appears in Collections:Aurora harvest 2
Public Health publications

Files in This Item:
File Description SizeFormat 
hdl_91754.pdfPublished version397.61 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.