Usefulness of PUMA and CAPTURE questionnaires as case-finding tools of COPD in a L-MIC

<bold>Introduction</bold>. COPD is the third cause of mortality in the world. Up to 85% of COPD mortality occurs in lower-middle income countries (L-MICs) and is associated with underdiagnosis due to underutilization of diagnostic tools to confirm cases. PUMA and CAPTURE questionnaires have showed a good accuracy to identify high-risk patients with COPD in high-income countries, but scarce data are available in L-MICs. <bold>Objectives</bold>. To analyze the accuracy of PUMA and CAPTURE questionnaires in population with COPD risk factors from Mexico. <bold>Methods:</bold>. Cross-sectional multicenter study applying PUMA and CAPTURE questionnaires to subjects older than 40 years, current of former smokers or biomass exposure complaining with dyspnea, cough and/or phlegm; regardless the score of the questionnaires, all patients performed spirometry following ATS/ERS 2019 standardization. <bold>Results:</bold>. 174 subjects completed PUMA and 51 CAPTURE questionnaires. Median age 64 years (IQR 55-73) and 53% were male. According to PUMA and CAPTURE score, 56% and 43% of the participants should perform a spirometry showing an obstructive pattern in 37% (FEV1 z-score: -1.50, IQR -2.40 to -0.31) and 55% (FEV1 z-score: -1.99, IQR -2.66 to -0.85) respectively. PUMA Sensitivity, specificity, PPV, NPV and AUC to confirm cases with an obstructive pattern were 87%, 51%, 37%, 87%, 0.65 (95% CI, 0.58-0.73); meanwhile for CAPTURE were 75%, 71%, 55%, 86%, 0.73 (95% CI, 0.60-0.87). <bold>Conclusions:</bold>. In a L-MIC, subjects with risk factors for COPD, PUMA and CAPTURE questionnaires are sensitive, but moderate certainty to diagnose patients with a spirometric obstructive pattern. PUMA identified early functional stages meanwhile CAPTURE those with advanced obstructive pattern.