Web-Based COPD Risk Self-Assessment Identifies a High-Risk Group With HRQoL Resembling Self-Reported COPD: Cross-Sectional Survey

This study aimed to evaluate a web-based self-assessment tool for COPD case finding using algorithm-based COPD risk stratification, and to compare breathlessness (mMRC) and respiratory health-related quality of life (HRQoL) across risk groups and with self-reported COPD. We conducted a cross-sectional web-based survey of anonymous visitors completing a web-based self-assessment tool including demographics, COPD risk factors, breathlessness (mMRC), and respiratory HRQoL (CAT and K-BILD). Only respondents with complete responses were analyzed. COPD risk was algorithmically classified as high- or low-risk based on responses to age, smoking or dust exposure, respiratory symptoms, history of exacerbations, and the mMRC score. Individuals classified as having a high-risk of COPD received a prompt recommendation to consult their general practitioners. Group comparisons were performed using chi-square or ANCOVA, adjusting for covariates (age, sex, and current smoking). All analyses were exploratory, without corrections for multiple testing. In total, 57 847 people visited the website between Oct 2018 and Nov 2024, of whom 8779 (63% female) completed the full survey. Of those 8779 (63% female), 799 reported a COPD diagnosis (mean age 64.1 years). The high-risk (n = 6569) and the low-risk (n = 1411) groups were younger than the self-reported COPD group (58.4, and 54.6 vs 60.1 years, P < .0001). Self-reported COPD was associated with a lower proportion of never smokers than the high- and low-risk groups (7.1% vs 15.0% and 22.0%, respectively; P < .0001). Individuals with self-reported COPD had greater breathlessness (mMRC: 1.74 ± 1.28, 1.39 ± 1.0 and 0 ± 0) and poorer HRQoL (CAT 18.9 ± 7.9, 15.9 ± 8.0 and 10.6 ± 5.5; K-BILD 64.4 ± 19.2, 73.1 ± 18.6 and 87.4 ± 12.8) than both high- and low-risk groups (all P < .0001). Breathlessness and respiratory HRQoL differed across algorithm-based COPD risk stratification groups, and the algorithmically identified high-risk group showed a profile closer to self-reported COPD than the low-risk group. These findings support a web-based self-assessment tool as an approach for early COPD case finding and identifying undiagnosed COPD, although further validation is required.