Utilidad del dispositivo portátil Piko-6 para la detección precoz de la enfermedad pulmonar obstructiva crónica en atención primaria / Usefulness of The Piko-6 Portable Device for Early COPD Detection in Primary Care

Introducción: La EPOC es una enfermedad de elevada prevalencia pero infradiagnosticada, debido a la escasa implantación de la espirometría forzada (EF) en atención primaria. Los microespirómetros, baratos y de manejo sencillo, que pueden medir FEV6 y FEV1/FEV6, podrían contribuir a reducir el infradiagnóstico. El objetivo del estudio ha sido validar el dispositivo Piko-6 para el cribado de la EPOC, demostrando una buena correlación con la EF convencional. Métodos: Se han realizado una EF y una determinación con Piko-6 a 155 pacientes susceptibles de padecer EPOC. Se han comparado las correlaciones, curvas ROC e índice de Youden con ambos métodos, considerando la EF como patrón de referencia. Resultados: Los coeficientes de correlación de FEV1, FVC y FEV6 y los cocientes FEV1/FVC y FEV1/FEV6 fueron de 0,87 (IC 95%: 0,836-0,909), 0,729 (IC 95%: 064-0,795) y 0,947 (IC 95%: 0,928-0,961) respectivamente. La curva ROC para el FEV1 determinado por Piko-6 alcanzó un área bajo la curva de 0,86 (IC 95%: 0,78-0,92). El índice de Youden para el punto de corte de 0,70 del FEV1/FEV6 fue 0,97. Conclusiones: El Piko-6 puede ser útil para el cribado de la EPOC en atención primaria. Sus determinaciones presentan buena correlación con las obtenidas mediante EF, especialmente el cociente FEV1/FEV6. Esto, junto a su bajo coste y facilidad de uso, puede contribuir a reducir el infradiagnóstico de la EPOC, aunque su rol exacto en el proceso diagnóstico está aún por determinar

Introduction: COPD is a highly prevalent but underdiagnosed disease, due to the limited availability of forced spirometry (FS) in primary care (PC). Microspirometers are inexpensive, easy-to-use devices that can measure FEV6 and FEV1/FEV6, and may help reduce underdiagnosis. The aim of this study was to validate the Piko-6 COPD screening device by demonstrating a good correlation with standard FS. Methods: FS and Piko-6 determinations were made in 155 patients suspected of having COPD. The correlations, ROC curves, and Youden's index of both methods were compared, taking FS as the gold standard. Results: FEV1, FVC and FEV6 correlation coefficients and FEV1/FVC and FEV1/FEV6 ratios were 0.87 (CI 0.836-0.909), 0.729 (CI 064-0.795) and 0.947 (95% CI 0.928-0.961), respectively. The ROC curve for FEV1 determined by Piko-6 achieved an area under the curve of 0.86 (95% CI: 0.78-0.92). Youden's index with a cut-off point of 0.70 for FEV1/FEV6 was 0.97. Conclusions: Piko-6 may be useful for COPD screening in PC. Measurements obtained with this device correlate well with those determined by FS, particularly the FEV1/FEV6 ratio. This, combined with its low cost and ease of use, may contribute to reducing COPD underdiagnosis, although its exact role in the diagnostic process remains to be determined

Usefulness of The Piko-6 Portable Device for Early COPD Detection in Primary Care. / Utilidad del dispositivo portátil Piko-6 para la detección precoz de la enfermedad pulmonar obstructiva crónica en atención primaria.

INTRODUCTION: COPD is a highly prevalent but underdiagnosed disease, due to the limited availability of forced spirometry (FS) in primary care (PC). Microspirometers are inexpensive, easy-to-use devices that can measure FEV6 and FEV1/FEV6, and may help reduce underdiagnosis. The aim of this study was to validate the Piko-6 COPD screening device by demonstrating a good correlation with standard FS. METHODS: FS and Piko-6 determinations were made in 155 patients suspected of having COPD. The correlations, ROC curves, and Youden's index of both methods were compared, taking FS as the gold standard. RESULTS: FEV1, FVC and FEV6 correlation coefficients and FEV1/FVC and FEV1/FEV6 ratios were 0.87 (CI 0.836-0.909), 0.729 (CI 064-0.795) and 0.947 (95% CI 0.928-0.961), respectively. The ROC curve for FEV1 determined by Piko-6 achieved an area under the curve of 0.86 (95% CI: 0.78-0.92). Youden's index with a cut-off point of 0.70 for FEV1/FEV6 was 0.97. CONCLUSIONS: Piko-6 may be useful for COPD screening in PC. Measurements obtained with this device correlate well with those determined by FS, particularly the FEV1/FEV6 ratio. This, combined with its low cost and ease of use, may contribute to reducing COPD underdiagnosis, although its exact role in the diagnostic process remains to be determined.