The Cost-Effectiveness of Mini Peak Expiratory Flow as a
Screening Test for Chronic Obstructive Pulmonary Disease
among the Bangkok Elderlyt
NANTA MARANETRA, MD, FRACP, FRCP*, BENJAMAS CHUAYCHOO, MD*,
CHANA NARUMAN, MSc*, JARIYA LERTAKYAMANEE, MD**,
WA NCHAI DEJSOMRITRUTA I, MD, MSc*, NITIPATANA CHIERAKUL, MD*,
ARTH NANA, MD*, WISANU THAMLIKITKUL, MD***,
T ASNEEY A SUTHAMSMAI, MSc*, SUTEE SAENGKAEW, BN*,
WICHEAN SREELUM, Dip.MST*, MONTCHAI AKSORNIN, Dip.AN*,
AMOLW AN DECHAPOL, BA *, CHAIRA T REUNGCHAM, Dip.AN*
Affiliation : * Division of Respiratory Disease and Tuberculosis, Department of Medicine,
** Department of Anaesthesiology,
*** Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700,
Thailand.
t Financially supported by National Research Council of Thailand.
AbstractThis study aims to explore the cost-effectiveness of Mini Peak Expiratory Flow (miniPEF) as
a screening test for Chronic Obstructive Pulmonary Disease (COPD) among the elderly in 124 urban
communities around Siriraj Hospital, using the gold standard of diagnosis based on the guidelines of
the Thoracic Society of Thailand. There were 3,094 subjects who participated and completed all the
tests. The results showed that the cut-off miniPEF percentage of predicted value of highest average
accuracy was 62 per cent. The sensitivity was 72.7 per cent (95% CI 67 .0-78.6) and the specificity was
81.1 per cent (95% CI 79.7-82.5) The cost of screening 19 elderly to detect one case of COPD is 923
baht, with a false negative rate of 1.9 per cent (95% CI 1.3-2.5%) and a false positive rate of 17.5 per
cent (95% CI 15.4-19.6%). It is suggested that measuring a miniPEF is regarded as one of the cost
effective screening tests for COPD in the elderly.
Keywords : COPD, Elderly, miniPEF, Cost-effectiveness, Screening
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