The Effectiveness of Peak Flow Meter in COPD Screening_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LiuYa'nan ,  XuWenbing , MengShuzhen , ZhaoYang , GuanWeiwei

Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China;

Corresponding?author：

XuWenbing, Email: xuwenbing60@qq.com

Keywords：

Chronic obstructive pulmonary disease; Peak flow meter; Peak expiratory flow; Screening

DOI：

10.7507/1671-6205.2015062

Video：

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Objective To analyze the sensitivity of peak flow meter screening in different subgroups of chronic obstructive pulmonary disease (COPD). Methods A total of 156 outpatients with COPD from Peking Union Medical Hospital from May 2013 to December 2014 were recruited in the study. Each patient's symptoms,history of exposure to risk factors,and the times of exacerbation in last year was recorded. All patients completed CAT,mMRC,the St George's Respiratory Questionnaire (SGRQ),6 minutes walking test,spirometry,and peak expiratory flow (PEF) by peak flow meter. Results Using the cut-off of PEF%pred=80%,the PEF detected 120 COPD patients in 156 subjects. The predictive factors of abnormal PEF%pred in COPD was FEV₁%pred and the total score of SGRQ (P<0.05). PEF screening could identify 76.9% of COPD patients,30.0%-60.0% of patients of less symptoms (mMRC<2 or CAT<10 or SGRQ<25),83.3%-90.9% of COPD patients with more symptoms (mMRC ≥ 2 or CAT ≥ 10 or SGRQ ≥ 25),27.7% of COPD patients with mild airflow limitation,68.5% of COPD patients with moderate airflow limitation,83.3% of COPD patients with moderate to very severe airflow limitation. When grouped by GOLD combined assessment method,PEF screening could identify 35.2% of patients of group A,75.0% of patients of group B,and 95.9% of patients of group C and D. The cut-off value of PEF% pred=80% showed low sensitivity to early stage of COPD,but when using the cut-off value of PEF% pred=95%,that sensitivity increased signifcantly. Conclusions Peak flow meter may be used as a tool to screen COPD. It can identify part of COPD patients especially for those patients with more symptoms,requiring regular treatment,with deteriorated pulmonary function and high risk of exacerbation.

Citation： LiuYa'nan, XuWenbing, MengShuzhen, ZhaoYang, GuanWeiwei. The Effectiveness of Peak Flow Meter in COPD Screening. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(3): 250-254. doi: 10.7507/1671-6205.2015062 Copy

1.	?Miller MR,Dickinson SA,Hitchings DJ. The accuracy of portable peak flow meters. Thorax,1992,47:904-909.
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8.	Zhong N,Wang C,Yao W,et al. Prevalence of chronic obstructive pulmonary disease in China:a large,population-based survey. Am J Respir Crit Care Med,2007,176:753-760.
9.	何權瀛,趙倩,葉阮健,等.我國部分省市慢性阻塞性肺疾病診斷中肺功能測定情況初步調查.中華結核和呼吸雜志,2003,26:39-40.
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12.	滕翠麗,張錦.PEF與COPD氣流阻塞判定指標的相關性研究.學位論文,寧夏醫科大學,2013.
13.	Nelson SB,LaVange LM,Nie Y,et al. Questionnaires and pocket spirometers provide an alternative approach for COPD screening in the general population.Chest,2012,142:358-366.
14.	Perez-Padilla R,Vollmer WM,Vazque-Garcia JC,et al. Can a normal peak expiratory flow exclude severe chronic obstruction pulmonary disease? Int J Tuberc Lung Dis,2009,13:387-393.
15.	Pushparajah S,McClellan R,Henry A. Use of a chronic disease management programme in COPD to reduce hospital admissions. Chron Respir Dis,2006,3,187-193.
16.	Jones KP,Mullee MA. Measuring peak expiration flow in general practice:comparison of mini Wright peak flow meter and turbine spirometer. BMJ,1990,300:1629-1631.
17.	Gregg I. PEF versus FEV₁. Thorax,2000,55:807-810.
18.	Bongers T,O'Driscoll BR. Effects of equipment and technique on peak flow measurements. BMC Pulm Med,2006,6:14.

1. ?Miller MR,Dickinson SA,Hitchings DJ. The accuracy of portable peak flow meters. Thorax,1992,47:904-909.
2. 田佳,冉丕鑫.成人PEF預計值公式建立及其在COPD患者中的氣流受限初篩中作用研究.學位論文,廣州醫學院,2010.
3. Jones PW,Bosh TK. Quality of life changes in COPD patients treated with salmeterol. Am J Respir Crit Care Med,1997,155:1283-1289.
4. Agusti A,Calverley PM,Celli B,et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res,2010,11:122.
5. Global initiative for chronic obstructive lung disease,updated 2015.http://www.goldcopd.com.
6. Miller MR,Hankinson J,Brusasco V,et al. Standardisation of spirometry. Eur Respir J,2005,26:319-338.
7. 鐘南山,張宇光,余幕潔,等.最大呼氣流量正常值及其在支氣管哮喘中的應用.中華結核和呼吸雜志,1985,8:134-141.
8. Zhong N,Wang C,Yao W,et al. Prevalence of chronic obstructive pulmonary disease in China:a large,population-based survey. Am J Respir Crit Care Med,2007,176:753-760.
9. 何權瀛,趙倩,葉阮健,等.我國部分省市慢性阻塞性肺疾病診斷中肺功能測定情況初步調查.中華結核和呼吸雜志,2003,26:39-40.
10. A?t-Khaled N,Enarson DA,Chiang CY. COPD management. Part Ⅱ. Relevance for resource-poor settings. Int J Tuberc Lung Dis,2008,12:595-600.
11. Jackson H,Hbbard R. Detecting chronic obstruction pulmonary disease using peak flow rate:cross sectional survey. BMJ,2003,327:653-654.
12. 滕翠麗,張錦.PEF與COPD氣流阻塞判定指標的相關性研究.學位論文,寧夏醫科大學,2013.
13. Nelson SB,LaVange LM,Nie Y,et al. Questionnaires and pocket spirometers provide an alternative approach for COPD screening in the general population.Chest,2012,142:358-366.
14. Perez-Padilla R,Vollmer WM,Vazque-Garcia JC,et al. Can a normal peak expiratory flow exclude severe chronic obstruction pulmonary disease? Int J Tuberc Lung Dis,2009,13:387-393.
15. Pushparajah S,McClellan R,Henry A. Use of a chronic disease management programme in COPD to reduce hospital admissions. Chron Respir Dis,2006,3,187-193.
16. Jones KP,Mullee MA. Measuring peak expiration flow in general practice:comparison of mini Wright peak flow meter and turbine spirometer. BMJ,1990,300:1629-1631.
17. Gregg I. PEF versus FEV₁. Thorax,2000,55:807-810.
18. Bongers T,O'Driscoll BR. Effects of equipment and technique on peak flow measurements. BMC Pulm Med,2006,6:14.

Chinese Journal of Respiratory and Critical Care Medicine

The Effectiveness of Peak Flow Meter in COPD Screening

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