Dynamic performance and scenario-based screening strategy of six COPD questionnaires: a cross-sectional study with prevalence-driven robustness validation

A "Scenario-Priority" strategy is proposed: For rule-out screening, use high-sensitivity tools (Modified-IPAG/LFQ); for high-risk identification, prioritize robust COPD-PS; in low-prevalence regions (<30%), use high-specificity SQ. This approach transcends the conventional "tool-first" static framework, delivering evidence-based support for precision COPD screening implementation.