Environmental Public Health Commons^™

Development Of The Lung Function Questionnaire (Lfq) To Identify Airflow Obstruction, Barbara P. Yawn, Douglas W. Mapel, David M. Mannino, Fernando J. Martinez, James F. Donohue, Nicola A. Hanania, Mark Kosinski, Regina Rendas-Baum, Matthew Mintz, Steven Samuels, Anand A. Dalal

David M. Mannino

Objective:

To describe the item-selection and item-reduction for the Lung Function Questionnaire (LFQ), being developed to help clinicians identify patients appropriate for diagnostic evaluation for chronic obstructive pulmonary disease (COPD) using spirometry.

Methods:

Item selection and reduction were based on information from 387 ≥40-year-old respondents to the third National Health and Nutrition Examination Survey who had self-reported chronic bronchitis. Item reduction involved stepwise logistic regression. The accuracy of the final subset of items for identifying individuals with airflow obstruction (forced expiratory volume in one second/forced vital capacity <0.70) versus those without it was assessed with receiver operating characteristic analysis. Content and face validity were assessed using focus groups of primary care physicians (n = 16) and interviews with COPD patients (n = 16).

Results:

The model with all five items (age; smoking history; the presence of …

Prevalence Of Copd Among Symptomatic Patients In A Primary Care Setting, Barbara Yawn, David M. Mannino, Thomas Littlejohn, Gary Ruoff, Amanda Emmett, Ibrahim Raphiou, Glenn Crater

David M. Mannino

Objective: Spirometry is recognized as the gold standard assessment for the diagnosis of COPD. However, spirometry continues to be underused, perpetuating the underdiagnosis of COPD. The aim of this study was to evaluate the prevalence of COPD in a primary care setting in patients with a smoking history and self-reported chronic bronchitis symptoms.

Research design and methods: This was a multi-center, cross-sectional study. The primary assessment was the percentage of patients with airway obstruction (post-bronchodilator FEV1/FVC ratio ≤ 0.70) compared to those without obstruction (post-bronchodilator FEV1/FVC ratio > 0.70).

Results: Airflow obstruction consistent with COPD was confirmed in 26% of patients …

What Is The Cost To Employers Of Direct Medical Care For Chronic Obstructive Pulmonary Disease?, Tursynbek Nurmagambetov, Adam Atherly, Seymour Williams, Fernando Holguin, David M. Mannino, Stephen C. Redd

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the United States. In 2000, an estimated 10.5 million people had COPD, of which more than 7.2 million were from the under-age 65 employed population. The prevalence of COPD in the workforce population was substantial with 46.5% of current employment among adults having the disease. However, the cost burden in the employed population is unknown. We examined COPD prevalence and costs in a large employment-based population. Using claims data from 1999 to 2003, we estimated the cost associated with COPD-related hospitalizations, emergency department visits, outpatient services, …