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The challenges of recruiting never-smokers with chronic obstructive pulmonary disease from the large population-based Swedish CArdiopulmonary bioImage study (SCAPIS) cohort

Sönnerfors, Pernilla ; Jacobson, Petra Kristina ; Andersson, Anders ; Behndig, Annelie ; Bjermer, Leif LU ; Blomberg, Anders ; Blomqvist, Heléne ; Erjefält, Jonas LU ; Friberg, Maria and Lamberg Lundström, Kristina , et al. (2024) In European clinical respiratory journal 11(1).
Abstract

Background: A substantial proportion of individuals with COPD have never smoked, and it is implied to be more common than previously anticipated but poorly studied. Aim: To describe the process of recruitment of never-smokers with COPD from a population-based cohort (n = 30 154). Methods: We recruited never-smokers with COPD, aged 50–75 years, from six University Hospitals, based on: 1) post broncho-dilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 0.70 and 2) FEV1 50–100% of predicted value and 3) being never-smokers (self-reported). In total 862 SCAPIS participants were identified, of which 652 were reachable and agreed to a first screening by telephone. Altogether 128 (20%) were... (More)

Background: A substantial proportion of individuals with COPD have never smoked, and it is implied to be more common than previously anticipated but poorly studied. Aim: To describe the process of recruitment of never-smokers with COPD from a population-based cohort (n = 30 154). Methods: We recruited never-smokers with COPD, aged 50–75 years, from six University Hospitals, based on: 1) post broncho-dilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 0.70 and 2) FEV1 50–100% of predicted value and 3) being never-smokers (self-reported). In total 862 SCAPIS participants were identified, of which 652 were reachable and agreed to a first screening by telephone. Altogether 128 (20%) were excluded due to previous smoking or declined participation. We also applied a lower limit of normal (LLN) of FEV1/FVC (z-score<-1.64) according to the Global Lung Initiative to ensure a stricter definition of airflow obstruction. Results: Data on respiratory symptoms, health status, and medical history were collected from 492 individuals, since 32 were excluded at a second data review (declined or previous smoking), prior to the first visit. Due to not matching the required lung function criteria at a second spirometry, an additional 334 (68%) were excluded. These exclusions were by reason of: FEV1/FVC ≥0.7 (49%), FEV1 > 100% of predicted (26%) or z-score ≥ −1,64 (24%). Finally, 154 never-smokers with COPD were included: 56 (36%) women, (mean) age 60 years, FEV1 84% of predicted, FEV1/FVC: 0.6, z-score: −2.2, Oxygen saturation: 97% and BMI: 26.8 kg/m2. Conclusions: The challenges of a recruitment process of never-smokers with COPD were shown, including the importance of correct spirometry testing and strict inclusion criteria. Our findings highlight the importance of repeated spirometry assessments for improved accuracy in diagnosing COPD.

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type
Contribution to journal
publication status
published
subject
keywords
COPD, COPD diagnosis, never-smokers, population-based, recruitment, SCAPIS, spirometry
in
European clinical respiratory journal
volume
11
issue
1
article number
2372903
publisher
Taylor & Francis
external identifiers
  • scopus:85198645222
  • pmid:39015382
ISSN
2001-8525
DOI
10.1080/20018525.2024.2372903
language
English
LU publication?
yes
id
5369790e-74b7-4cd3-9c9f-2dbb73c6752b
date added to LUP
2024-11-28 10:21:33
date last changed
2025-05-30 01:25:20
@article{5369790e-74b7-4cd3-9c9f-2dbb73c6752b,
  abstract     = {{<p>Background: A substantial proportion of individuals with COPD have never smoked, and it is implied to be more common than previously anticipated but poorly studied. Aim: To describe the process of recruitment of never-smokers with COPD from a population-based cohort (n = 30 154). Methods: We recruited never-smokers with COPD, aged 50–75 years, from six University Hospitals, based on: 1) post broncho-dilator forced expiratory volume in 1 second/forced vital capacity (FEV<sub>1</sub>/FVC) &lt; 0.70 and 2) FEV<sub>1</sub> 50–100% of predicted value and 3) being never-smokers (self-reported). In total 862 SCAPIS participants were identified, of which 652 were reachable and agreed to a first screening by telephone. Altogether 128 (20%) were excluded due to previous smoking or declined participation. We also applied a lower limit of normal (LLN) of FEV<sub>1</sub>/FVC (z-score&lt;-1.64) according to the Global Lung Initiative to ensure a stricter definition of airflow obstruction. Results: Data on respiratory symptoms, health status, and medical history were collected from 492 individuals, since 32 were excluded at a second data review (declined or previous smoking), prior to the first visit. Due to not matching the required lung function criteria at a second spirometry, an additional 334 (68%) were excluded. These exclusions were by reason of: FEV<sub>1</sub>/FVC ≥0.7 (49%), FEV<sub>1</sub> &gt; 100% of predicted (26%) or z-score ≥ −1,64 (24%). Finally, 154 never-smokers with COPD were included: 56 (36%) women, (mean) age 60 years, FEV<sub>1</sub> 84% of predicted, FEV<sub>1</sub>/FVC: 0.6, z-score: −2.2, Oxygen saturation: 97% and BMI: 26.8 kg/m<sup>2</sup>. Conclusions: The challenges of a recruitment process of never-smokers with COPD were shown, including the importance of correct spirometry testing and strict inclusion criteria. Our findings highlight the importance of repeated spirometry assessments for improved accuracy in diagnosing COPD.</p>}},
  author       = {{Sönnerfors, Pernilla and Jacobson, Petra Kristina and Andersson, Anders and Behndig, Annelie and Bjermer, Leif and Blomberg, Anders and Blomqvist, Heléne and Erjefält, Jonas and Friberg, Maria and Lamberg Lundström, Kristina and Lundborg, Anna and Malinovschi, Andrei and Persson, Hans Lennart and Tufvesson, Ellen and Wheelock, Åsa and Janson, Christer and Sköld, Carl Magnus}},
  issn         = {{2001-8525}},
  keywords     = {{COPD; COPD diagnosis; never-smokers; population-based; recruitment; SCAPIS; spirometry}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{European clinical respiratory journal}},
  title        = {{The challenges of recruiting never-smokers with chronic obstructive pulmonary disease from the large population-based Swedish CArdiopulmonary bioImage study (SCAPIS) cohort}},
  url          = {{http://dx.doi.org/10.1080/20018525.2024.2372903}},
  doi          = {{10.1080/20018525.2024.2372903}},
  volume       = {{11}},
  year         = {{2024}},
}