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Prospective development of practical screening strategies for diagnosis of asthma-COPD overlap

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单位: [1]Cent South Univ, Xiangya Hosp 2, Dept Resp & Crit Care Med, 139 Renmin Middle Rd, Changsha 410011, Hunan, Peoples R China [2]Cent South Univ, Res Unit Resp Dis, Changsha, Hunan, Peoples R China [3]Cent South Univ, Diag & Treatment Ctr Resp Dis, Changsha, Hunan, Peoples R China [4]Hunan Normal Univ, Hunan Prov Peoples Hosp, Dept Resp Med, Changsha, Hunan, Peoples R China [5]Peoples Hosp Guizhou Prov, Dept Resp Med, Guiyang, Guizhou, Peoples R China [6]Peking Univ, Hosp 3, Dept Resp Med, Beijing, Peoples R China [7]China Med Univ, Hosp 1, Dept Resp Med, Shenyang, Liaoning, Peoples R China [8]Fudan Univ, Zhong Shan Hosp, Dept Resp Med, Shanghai, Peoples R China [9]Guangxi Med Univ, Affiliated Hosp 1, Evidence Based Med Ctr, Nanning, Peoples R China [10]Cent South Univ, Xiangya Hosp 3, Dept Resp Med, Changsha, Hunan, Peoples R China [11]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Resp & Crit Care Med, Wuhan, Hubei, Peoples R China
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关键词: asthma-chronic obstructive pulmonary disease overlap diagnostic criteria screening model

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Background and objective: ACO is a syndrome with high prevalence. However, a pragmatic diagnostic criterion to differentiate ACO is non-existent. We aimed to establish an effective model for screening ACO. Methods: A multicentre survey was developed to assess the clinical criteria considered important and applicable by pulmonologists for screening ACO. These experts were asked to take the surveys twice. The expert grading method, analytic hierarchy process and ROC curve were used to establish the model, which was then validated by a cross-sectional study of 1066 patients. The GINA/GOLD document was the gold standard in assessing this model. Results: Increased variability of symptoms, paroxysmal wheezing, dyspnoea, historical diagnosis of COPD or asthma, allergic constitution, exposure to risk factors, the FEV1/FVC < 70% and a positive BDT were important for screening ACO. According to the weight of each criterion, we confirmed that patients meeting six or more of these eight criteria should be considered to have ACO. We called this Chinese screening model for ACO 'CSMA'. It differentiated patients with ACO with a sensitivity of 83.33%, while the sensitivity of clinician-driven diagnosis had a sensitivity of only 42.73%. Conclusion: CSMA is a workable model for screening ACO and provides a simple tool for clinicians to efficiently diagnose ACO.

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 3 区 呼吸系统
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 呼吸系统
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Q1 RESPIRATORY SYSTEM
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Q1 RESPIRATORY SYSTEM

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第一作者单位: [1]Cent South Univ, Xiangya Hosp 2, Dept Resp & Crit Care Med, 139 Renmin Middle Rd, Changsha 410011, Hunan, Peoples R China [2]Cent South Univ, Res Unit Resp Dis, Changsha, Hunan, Peoples R China [3]Cent South Univ, Diag & Treatment Ctr Resp Dis, Changsha, Hunan, Peoples R China
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通讯机构: [1]Cent South Univ, Xiangya Hosp 2, Dept Resp & Crit Care Med, 139 Renmin Middle Rd, Changsha 410011, Hunan, Peoples R China [2]Cent South Univ, Res Unit Resp Dis, Changsha, Hunan, Peoples R China [3]Cent South Univ, Diag & Treatment Ctr Resp Dis, Changsha, Hunan, Peoples R China
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