Work

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

Year: 2026

Type: article

Abstract: 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.

Source: npj Primary Care Respiratory Medicine

DOI: 10.1038/s41533-026-00510-9