Development of the Lung Function Questionnaire (LFQ) to identify airflow obstruction

Int J Chron Obstruct Pulmon Dis. 2010 Feb 18;5:1-10.


Objective: To describe the item-selection and item-reduction for the Lung Function Questionnaire (LFQ), being developed to help clinicians identify patients appropriate for diagnostic evaluation for chronic obstructive pulmonary disease (COPD) using spirometry.

Methods: Item selection and reduction were based on information from 387 > or =40-year-old respondents to the third National Health and Nutrition Examination Survey who had self-reported chronic bronchitis. Item reduction involved stepwise logistic regression. The accuracy of the final subset of items for identifying individuals with airflow obstruction (forced expiratory volume in one second/forced vital capacity <0.70) versus those without it was assessed with receiver operating characteristic analysis. Content and face validity were assessed using focus groups of primary care physicians (n = 16) and interviews with COPD patients (n = 16).

Results: The model with all five items (age; smoking history; the presence of wheeze, dyspnea, and phlegm) compared with models with combinations of fewer items had the highest classification accuracy (area under the curve [AUC] = 0.720) with sensitivity and specificity of 73.2% and 58.2%, respectively. The presence of three or more factors yielded the highest AUC, a result suggesting that three or more affirmative answers is the most appropriate criterion indicating presence of airflow obstruction.

Conclusions: The five-item LFQ retained sufficient accuracy, sensitivity, and specificity in identifying individuals with COPD for further validation testing.

Keywords: chronic bronchitis; chronic obstructive pulmonary disease; diagnosis; respiratory disease; screening; spirometry.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Focus Groups
  • Humans
  • Interviews as Topic
  • Lung / physiopathology
  • Male
  • Mass Screening / instrumentation*
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Spirometry
  • Surveys and Questionnaires / standards*