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Can CAPTURE be used to identify undiagnosed patients with mild-to-moderate COPD likely to benefit from treatment?



Nancy K Leidy, Fernando J Martinez, Karen G Malley, et al.
Int J Chron Obstruct Pulmon Dis 2018;13:1901–12
doi: 10.2147/COPD.S152226

Chronic obstructive pulmonary disease (COPD) Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE™) was developed to identify people with severe, high-risk, undiagnosed COPD in primary care settings, i.e. people with a forced expiratory volume in 1 second (FEV1) <60% predicted or exacerbation risk. Although screening of asymptomatic individuals for undiagnosed COPD is not recommended, it is conceivable that identifying symptomatic patients with mild-to-moderate airflow limitation could be advantageous.

 

The authors of this US study set out to learn if CAPTURE could identify patients with FEV1 60–80%. To do this, analyses were performed on data from the original CAPTURE control group (n=160), with cases defined by a diagnosis of COPD, FEV1 ≥60% predicted and no exacerbation in the prior 12 months (n=73) and those with no COPD serving as control (n=87). The entire dataset (n=346) was used to evaluate CAPTURE across the full range of COPD (n=259), with patients without COPD (n=87) serving as control.

 

Results of the analyses suggest that CAPTURE can be used to identify symptomatic patients likely to have airflow limitation and in need of further clinical evaluation for possible COPD. Further testing in a large prospective study of this case-finding approach and its effects on diagnosis, treatment and patient-centred outcomes are warranted.




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