Abstract
Background: Our objective was to determine how to select the optimal frequency of workplace spirometry screening using diacetyl-exposed workers as an example. Methods: A Markov model was constructed to assess the likelihood of progressing from healthy status to early or advanced disease, starting from four different exposure levels, and performing longitudinal or cross-sectional interpretation of spirometry results over time. Projected outcomes at 10 years were evaluated to inform the optimal frequency of workplace spirometry testing. Results: The optimal screening interval depends on the population risk and is highly sensitive to the real-life impact (utility) associated with false-positive results (eg, related to the availability of alternative work). Screening interval is particularly important for high-risk individuals with rapid transition from early to advanced disease, where the 10-year prevalence of advanced disease would be reduced from 5.3 to 2.5% using a 6-month interval rather than a 12-month interval. Longitudinal test interpretation, based on observing trends within each person over time, is marginally preferable to traditional cross-sectional spirometry interpretation. Conclusions: There is no single best screening interval. For high-risk populations, annual testing may be too infrequent.
Original language | English (US) |
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Pages (from-to) | 1086-1094 |
Number of pages | 9 |
Journal | CHEST |
Volume | 136 |
Issue number | 4 |
DOIs | |
State | Published - Oct 1 2009 |
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine