Use of vitalograph COPD-6 device as point of care screening tool for COPD in resource-limited settings

Abstract

Background: COPD is under-diagnosed in India due to unavailability of spirometry.Vitalograph COPD-6(Vitalograph Ltd,Ireland)is a simple,inexpensive device to screen COPD.

Aim: To determine accuracy of Vitalograph COPD-6 in screening for COPD,and assess reliability of device.

Methods: Between Dec2014-Feb2015,consecutive subjects undergoing spirometry at PD Hinduja Hospital,India were offered testing with Vitalograph COPD-6 by trained technicians using ATS criteria for quality control.FEV₁/FEV₆<0.8 was tested for screening of COPD.Postbronchodilator FEV1/FVC<0.7 on spirometry was used as reference(gold standard).11 volunteers were tested for 10 consecutive days to assess FEV1 repeatability.

Results: 298 subjects(269 undergoing annual health check-up)were enrolled in the study.30 subjects(10.1%) had COPD on spirometry.Vitalograph COPD-6 had sensitivity of 100%(95%CI 88,100),specificity 82%(95%CI 77,86),ROC area 0.91(95%CI 0.89,0.93).Median coefficient of variation of FEV₁ among 11 subjects tested daily was 2.2(IQR 1.7,2.7)

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Discussion: Vitalograph COPD-6 is sensitive and reliable for screening of COPD.It appears more sensitive than similar devices eg Piko-6 and screening questionnaires.It can serve as a valuable point-of-care screening tool.

Acknowledgement: The study was funded by “Project Québec-Maharashtra,Relations internationales et de la Francophonie,Quebec”.We thank Cipla Respiratory for providing us Vitalograph COPD-6.