PMID- 33290644
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210704
IS  - 2372-952X (Print)
IS  - 2372-952X (Electronic)
IS  - 2372-952X (Linking)
VI  - 8
IP  - 2
DP  - 2021 Apr 27
TI  - Improving Screening for Alpha-1 Antitrypsin Deficiency with Direct Testing in the 
      Pulmonary Function Testing Laboratory.
PG  - 190-197
LID - 10.15326/jcopdf.2020.0179 [doi]
AB  - Alpha-1 antitrypsin deficiency (AATD) is a common but highly underdiagnosed 
      genetic disorder that may lead to chronic obstructive pulmonary disease (COPD), 
      bronchiectasis, and liver disease. Early diagnosis is key to altering the course 
      of disease as well as informing family members of potential risk. This 
      randomized, prospective observational study compares the different testing 
      modalities for AATD testing of at-risk patients initiated in the pulmonary 
      function testing (PFT) laboratory. Providing a recommendation with a prescription 
      for serologic testing, providing a finger-stick testing method (AlphaKit), and 
      providing a buccal swab testing method (AlphaID) were compared to the community 
      standard of referring the patient back to the PFT-ordering provider only. Results 
      show that testing directly in the PFT laboratory has an odds ratio (OR) for 
      completing testing of 35.14 (5.33 - 999.99), p-value of <0.0001, for buccal swab 
      testing and an OR of 17.09 (2.58 - 729.99), p-value of 0.0002, for finger-stick 
      testing compared to the community standard. Providing a prescription was no 
      better than referral back to the PFT-ordering provider with an OR of 2.61(0.33 - 
      119.36), p-value of 0.6412. Resources needed to have testing performed by the 
      Respiratory Therapy department were minimal with an average time of 1 to 5 
      minutes per patient tested. Causes of testing refusal were also identified. In 
      conclusion, direct testing for AATD by respiratory therapists at the conclusion 
      of PFT testing shows a significant improvement in rates of testing, especially 
      with testing that utilizes buccal swab sample collection.
CI  - JCOPDF (c) 2021.
FAU - Gurevich, Samuel
AU  - Gurevich S
AD  - Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 
      Cleveland, Ohio, United States.
AD  - Department of Pulmonary Medicine, Cleveland Clinic Florida, Weston, Florida, 
      United States.
FAU - Daya, Andrew
AU  - Daya A
AD  - Department of Pulmonary Medicine, Cleveland Clinic Florida, Weston, Florida, 
      United States.
FAU - Da Silva, Cristiana
AU  - Da Silva C
AD  - Department of Pulmonary Medicine, Cleveland Clinic Florida, Weston, Florida, 
      United States.
FAU - Girard, Christine
AU  - Girard C
AD  - Department of Pulmonary Medicine, Cleveland Clinic Florida, Weston, Florida, 
      United States.
FAU - Rahaghi, Franck
AU  - Rahaghi F
AD  - Department of Pulmonary Medicine, Cleveland Clinic Florida, Weston, Florida, 
      United States.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Chronic Obstr Pulm Dis
JT  - Chronic obstructive pulmonary diseases (Miami, Fla.)
JID - 101635411
PMC - PMC8237974
OTO - NOTNLM
OT  - AlphaID
OT  - AlphaKit
OT  - alpha-1 antitrypsin deficiency
OT  - chronic obstructive pulmonary disease
OT  - copd
COIS- Frank Rahaghi is a consultant and speaker for Grifols and Takeda. All other 
      authors have nothing to declare.
EDAT- 2020/12/09 06:00
MHDA- 2020/12/09 06:01
PMCR- 2021/04/27
CRDT- 2020/12/08 17:19
PHST- 2020/12/09 06:00 [pubmed]
PHST- 2020/12/09 06:01 [medline]
PHST- 2020/12/08 17:19 [entrez]
PHST- 2021/04/27 00:00 [pmc-release]
AID - 10.15326/jcopdf.2020.0179 [doi]
PST - ppublish
SO  - Chronic Obstr Pulm Dis. 2021 Apr 27;8(2):190-197. doi: 10.15326/jcopdf.2020.0179.