Gil-Guillén et al. BMC Public Health 2011, 11:413 http://www.biomedcentral.com/1471-2458/11/413 Spirometry enables the primary care health profes- sional to make an objective measurement of airflow lim- itation and the degree to which it is reversible, and is an important tool for accurate diagnosis and effective man- agement of chronic respiratory diseases including asthma and COPD [17]. However, spirometry remains underused in primary care [18,19]. Barriers to perform- ing spirometry in community settings include lack of access to calibrated spirometers, inadequate training in performing spirometry, price of conventional spirom- eters, lack of quality-control systems to ensure accurate results, and inadequate interpretation skills among health professionals performing the test [20,21]. Having a simple screening tool adapted to the primary care setting would detect COPD in early stages and the number of patients referred to CS will be lower. It could help to establish a protocol to facilitate high risk people screening with high rates of compliance. This is an effort in terms of prevention, which can result in fewer later stages cases of the disease and consequently, better quality of life for patients. In addition it could help sav- ings for the healthcare burden. Abbreviations COPD: Chronic obstructive pulmonary disease; PPV: Positive predictive value; NPV: Negative predictive value; ROC: Receiver operating characteristics; PCP: Primary care physicians; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; BMI: Body mass index; CS: Conventional spirometry Acknowledgements and Funding This project was supported by an unrestricted grant from Exilio SI S.L. We gratefully thank FUMEPOC Study Research Team (Adoración Revert Algarra, Adriana López Pineda, Alejandro Muñoz Fernández, Alfredo Ruiz Paterna, Andrés Vicente Genovés Espulgues, Antonio Fernández, Antonio Llerena Herance, Antonio Medina Toro, Antonio Palacios del Cerro, Antonio Torrente Blasco, Asunción Antolín Llenares, Carlos Botella Estrada, Carlos Plaza Sirvent, Carmen Gallego Gonzalez, Carmen Gómez Martín, Concepción Albert Martínez, Concepción Carratalá Munuera, Damián Crespí Capó, Domingo Orozco Beltrán, Enrique Hermida Campa, Ernesto Viñes Martinez, Eugenio Mira Ramos, Fernando Díaz González, Francisco Ponce Lorenzo, Isabel Pastor Martínez, Joaquín Oriente Pérez, Jose Antonio Paradinas Rubio, Jose Luis Martínez Lázaro, Jose Mª Herrero de la Vega, Jose Vicente Vaquer Pérez, Juan Carlos Deltell Llorens, Juan José Soler, Juan Luis Hernández Juan, Luis Maestre Amat, Luis Rosado Bretón, Manuel Yarza Cañellas, Mª Carmen Martínez Suay, Mª Isabel Boix Vera, Mª Isabel Fernández Estébanez, Mª Pilar Vela Troncoso, Mª Rosa Saez Fernández, Manuel Cano Arjona, Manuel Carlos Salas Tomás, Marisa Asensio García, Miguel Angel García Lillo, Miguel Cuenca Navarro, Olga Mabel Siva Aguiar, Patricia López Anaya, Patricia Lorca Amorrich, Raquel Albert Muñoz, Roberto Jorge Jover Rico, Rosa Pastor López, Salvador Aguilar Pérez, Soledad García Beviá, Tertuliano Amat Sotos, Vicente Gil Guillén, Virginia García Gil) for undertaking the study. Author details 1Departamento Medicina Clínica, Universidad Miguel Hernández de Elche (Campus de San Juan), 03550 San Juan de Alicante, Alicante, Spain. 2Unidad Investigación, Hospital Universitario San Juan de Alicante, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d’Alacant (Alicante), Spain. 3Departamento Medicina Clínica, Universidad Miguel Hernández de Elche, Carretera Nacional 332 Alicante-Valencia s/n, 03550, Sant Joan d’Alacant (Alicante), Spain. 4Departamento de Medicina Interna, Hospital General de Elda (Alicante), Ctra. Sax-Elda, s/n, 03600, Elda, Spain. 5Servicio de Neumología, Hospital de Requena, Casablanca, S/N, 46340, Requena, Spain. 6Agencia Valenciana de Salud, Conselleria de Sanidad, Micer Mascó no 31, Page 5 of 6 46010, Valencia, Spain. 7Centro de Salud Villena II, Avenida Los toreros s/n, 03400, Villena (Alicante), Spain. 8Hospital General de Elda Virgen de la Salud, Ctra. de Sax s/n, 03600, Elda, Spain. Authors’ contributions VG, DO and CVCM participated in the design of the study. VG, DO, CVCM, CP, PL, AL, and MPV contributed to the protocol development. CP, PL, AL, and MPV participated in the manuscript writing. JJS, MY, LR, CO, AM and AF contributed to the manuscript review. All the authors have read the draft critically, to make contributions, and have approved the final text. Competing interests The authors declare that they have no competing interests. Received: 22 February 2011 Accepted: 31 May 2011 Published: 31 May 2011 References 1. Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2008 [http://www.goldcopd.com/ Guidelineitem.asp?l1=2&l2=1&intId=989], Accessed May 2011. 2. Celli BR, MacNee W, ATS/ERS Task Force: Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. 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