Table 3 COPD-population screener™ (mod)

Mark with a cross the box of the answer that best describes the situation.

The number beside the box serves to calculate the final score.

1. In the last two weeks how many times did you have the sensation of being out of breath?

□ 0 rarely or never

□ 1 sometimes

□ 2 almost always

□ 2 always

2. Does it ever happen when you cough that you feel catarrh or mucus moves?

□ 0 only occasionally when I have a cold or ‘flu’

□ 1 a few days per month

□ 1 most days of the week

□ 2 every day of the week

3. What is the answer to the following question that best describers your situation in the last 12 months:

“I do less than I used to because I have breathing problems”

□ 0 I don’t think so

□ 1 this happens to me sometimes

□ 2 it’s exactly like that

4. Have you smoked more than 100 cigarettes in your whole life?

□ 0 no

□ 2 yes

5. How old are you?

□ 0 from 35 to 49

□ 1 from 50 to 59

□ 2 from 60 to 69

□ 2 over 70

Total score: ____________________

If the total is 5 or more your breathing problems could be caused by a disease that is known as pulmonary emphysema or chronic bronchitis and that doctors call chronic obstructive pulmonary disease (COPD). Talk about it with your doctor, reporting the answers given to this questionnaire. Remember anyhow that any breathing problem, even banal but which lasts a few weeks or months, could be the signal of a lung disease; to exclude this it would be a good idea to talk about it with your GP.