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<p>The PUMA scale has shown good discrimination in identifying people with COPD in primary care. We evaluated the predictive performance of PUMA for opportunistic case-finding and assessed the prevalence of COPD in at-risk primary care patients in Singapore. This is a multicentre cross-sectional study of participants aged ≥40 years and current/former smokers. Participants completed the PUMA scale and spirometry. Predictive performance of PUMA was assessed using AUC-ROC; optimal cutoff was determined by Youden’s index. 359 participants were included in final analysis; 12.5% had COPD confirmed on spirometry. PUMA showed acceptable discrimination with AUC-ROC of 0.75 (95% CI:0.67–0.83). Optimal cutoff maximising sensitivity and specificity was ≥5 (Se 62.2%, Sp 79.3%; PPV 30.1%, NPV 93.6%); cutoff of ≥4 increased sensitivity to 80.0% (Sp of 56.7%; PPV 20.9%, NPV 95.2%.). The PUMA scale demonstrated acceptable predictive performance for opportunistic COPD case-finding in Singapore’s primary care setting. A cutoff of ≥4 enhanced case identification.</p>

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Predictive performance of the PUMA questionnaire as an opportunistic COPD case-finding tool in Singapore primary care

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月14日

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  • Vicky Mengqi Qin,
  • Kenneth Tan,
  • Geak Poh Tan,
  • Valery Ho,
  • Zeyuan Yin,
  • Susie Wong,
  • Dingding Wang,
  • Jo-Anne Manski-Nankervis,
  • Eng Sing Lee

摘要

The PUMA scale has shown good discrimination in identifying people with COPD in primary care. We evaluated the predictive performance of PUMA for opportunistic case-finding and assessed the prevalence of COPD in at-risk primary care patients in Singapore. This is a multicentre cross-sectional study of participants aged ≥40 years and current/former smokers. Participants completed the PUMA scale and spirometry. Predictive performance of PUMA was assessed using AUC-ROC; optimal cutoff was determined by Youden’s index. 359 participants were included in final analysis; 12.5% had COPD confirmed on spirometry. PUMA showed acceptable discrimination with AUC-ROC of 0.75 (95% CI:0.67–0.83). Optimal cutoff maximising sensitivity and specificity was ≥5 (Se 62.2%, Sp 79.3%; PPV 30.1%, NPV 93.6%); cutoff of ≥4 increased sensitivity to 80.0% (Sp of 56.7%; PPV 20.9%, NPV 95.2%.). The PUMA scale demonstrated acceptable predictive performance for opportunistic COPD case-finding in Singapore’s primary care setting. A cutoff of ≥4 enhanced case identification.