Comparison of the Diagnostic Performance of Five Clinical Questionnaires for Chronic Obstructive Pulmonary Disease.

Background: Chronic obstructive pulmonary disease (COPD) remains one of the most prevalent pathologies in the world and is among the leading causes of mortality and morbidity, partially due to underdiagnosis. The use of clinical questionnaires to identify high-risk individuals to take them to further diagnostic procedures has emerged as a strategy to address this problem. Objective: To compare the performance of the COULD IT BE COPD, CDQ, COPD-PS, LFQ, and PUMA questionnaires for COPD diagnosis. Methods: A cross-sectional study was carried out on subjects who underwent spirometry in the third-level center. Data were collected between January 2015 and March 2020. Bivariate analysis was performed between the study variables and the presence of COPD. The area under the receiver operating characteristics curve (AUC-ROC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) for each questionnaire were calculated. The AUC-ROCs were compared with the DeLong test, considering a p value <0.05 statistically significant. Results: 681 subjects met the inclusion criteria and were taken to the final analysis. The prevalence of COPD was 27.5% (187/681). The mean age of the subjects was 65.9 years (SD ± 11.79); 46.3% (315/681) were female, and 83.6% (569/681) reported respiratory symptoms. Statistically significant relationship was found for COPD diagnosis with male sex, older age, respiratory symptoms, and exposure to wood smoke (p value <0.05). The AUC-ROCs of the questionnaires were between 0.581 and 0.681. The COULD IT BE COPD questionnaire had a lower discriminatory capacity AUC-ROC of 0.581, concerning the other scores (DeLong test, p = 0.0002). Conclusion: The CDQ, COPD-PS, LFQ, PUMA, and COULD IT BE COPD questionnaires have acceptable performance for the diagnosis of COPD together with low sensitivity and specificity. Therefore, its use must be complemented with other diagnostic tests or techniques such as pulmonary function tests.

Increasing diversity in research through dedicated language access services.

In the context of research, one challenge at higher education and medical institutions that are engaged in high levels of research activities is recruiting and enrolling participants for research studies and clinical trials (1) who are of diverse racial and ethnic backgrounds and (2) whose primary language is not English. By 2020, of the 330 million people living in the U.S., 63% identified as White, 17% identified as Hispanic, 13% identified as Black, 5% identified as Asian, and 1% identified as other. With this shift in ethnic and racial demographics, researchers need to update their methods of recruitment as well as the information and documents provided about research opportunities. The University of Utah's Office Research Participant Advocacy (RPA) was created at the University of Utah in 2008 with an aim to identify and support individuals volunteering for research study participation. The focus of the important and uniquely situated office is to ensure that participants have the information they need for informed research participation, but also to provide researchers with oral and written language services to increase participant diversity in research studies. This short communication describes efforts underway at the RPA to ensure that information about and documents connected to research opportunities are congruent with the needs of research participants and offer equity for participation in research for a shifting cohort of diverse individuals.