Letter to the Editor
Reply to COPD diagnosis in EPI-SCAN II
Respuesta a «El diagnóstico de la EPOC en EPI-SCAN II»
Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain
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"apellidos" => "Soriano" "email" => array:1 [ 0 => "jbsoriano2@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "colaborador" => "On behalf of the Scientific Committee EPI-SCAN II" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta a «El diagnóstico de la EPOC en EPI-SCAN II»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the letter from Dr. López-Campos and Dr. Alcázar<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> commenting on the EPI-SCAN II<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> study, and we thank them for the opportunity to discuss three relevant aspects of population research in general and COPD in particular.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Firstly, we fully agree that it is important to encourage the debate between airflow limitation and clinical COPD. In this respect, EPI-SCAN II used the same COPD criteria universally accepted in epidemiological studies, and that were also used in EPI-SCAN I in order to compare results. Comparisons between participants diagnosed with COPD according to these criteria or by clinical criteria, in addition to spirometry, is one of the secondary objectives of the study that will be analyzed in a future publication.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Secondly, the entire methodology of the EPI-SCAN II study, including its sampling strategy, is summarized in the <a href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</a> repository, under number NCT03028207, and in the methods section of our article. It is, furthermore, described in more detail in the protocol previously published in <span class="elsevierStyleSmallCaps">Archivos de Bronconeumología.</span><a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Finally, with regard to possible selection biases, we admit that the methodology we used may not be completely bias-free, but it was the best alternative available to conduct a study of these dimensions. Performing spirometries in the general population is not easy. Choosing major cities or provincial capitals does not in itself constitute a selection bias, but was instead a reasoned methodological decision, since the practical aspects of inviting people who live at some distance from a hospital to participate altruistically in a research study are much more complex and expensive than conducting the study in the inhabitants of an urban capital, where research teams and certified lung function laboratories are concentrated. We agree that telephone sampling may potentially lead to a selection bias, but given the current legal impossibility of performing any kind of census sampling we felt postal or internet sampling alternatives were no better. These limitations have already been recognized in the text of our article: “…<span class="elsevierStyleItalic">The majority of areas studied were urban, and although more than</span> 90% <span class="elsevierStyleItalic">of the Spanish population lives in cities, the population burden of disease in rural areas is expected to be high but underrepresented here</span>”. There is little doubt that the problem of COPD and all other chronic diseases associated with smoking and aging in the so-called “empty Spain” is a specific issue that requires a different approach that was not among the objectives of EPI-SCAN II.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">The EPISCAN II study was funded by GSK.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Soriano JB. Respuesta a «El diagnóstico de la EPOC en EPI-SCAN II». Arch Bronconeumol. 2021;57:235.</p>" ] 1 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Members of the EPI-SCAN II Scientific committee are listed in the Appendix A.</p>" "identificador" => "fn0005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0030" class="elsevierStylePara elsevierViewall">Joan B Soriano (Hospital Universitario de La Princesa, Centro de Investigación en Red de Enfermedades Respiratorias [CIBERES], Instituto de Salud Carlos III [ISCIII], Madrid).</p> <p id="par0035" class="elsevierStylePara elsevierViewall">Inmaculada Alfageme (Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Seville).</p> <p id="par0040" class="elsevierStylePara elsevierViewall">Marc Miravitlles (Servicio de Neumología, Hospital Universitari Vall d’Hebron, Barcelona, Centro de Investigación en Red de Enfermedades Respiratorias [CIBERES], Instituto de Salud Carlos III [ISCIII], Madrid).</p> <p id="par0045" class="elsevierStylePara elsevierViewall">Pilar de Lucas (Servicio de Neumología, Hospital General Gregorio Marañón, Madrid).</p> <p id="par0050" class="elsevierStylePara elsevierViewall">Juan José Soler-Cataluña (Servicio de Neumología, Hospital Arnau de Vilanova-Llíria, Valencia).</p> <p id="par0055" class="elsevierStylePara elsevierViewall">Francisco García-Río (Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Centro de Investigación en Red de Enfermedades Respiratorias [CIBERES], Instituto de Salud Carlos III [ISCIII], Madrid).</p> <p id="par0060" class="elsevierStylePara elsevierViewall">Ciro Casanova (Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Tenerife).</p> <p id="par0065" class="elsevierStylePara elsevierViewall">José Miguel Rodríguez González-Moro (Servicio de Neumología, Hospital Universitario de Alcalá de Henares, Madrid).</p> <p id="par0070" class="elsevierStylePara elsevierViewall">Borja G. Cosío (Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Centro de Investigación en Red de Enfermedades Respiratorias [CIBERES], Instituto de Salud Carlos III [ISCIII], Madrid).</p> <p id="par0075" class="elsevierStylePara elsevierViewall">Guadalupe Sánchez (Departamento Médico, GSK, Tres Cantos, Madrid).</p> <p id="par0080" class="elsevierStylePara elsevierViewall">Julio Ancochea (Hospital Universitario de La Princesa, Centro de Investigación en Red de Enfermedades Respiratorias [CIBERES], Instituto de Salud Carlos III [ISCIII], Madrid)</p>" "etiqueta" => "Appendix A" "titulo" => "Annex List of members of the EPI-SCAN II scientific committee" "identificador" => "sec0010" ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "El diagnóstico de la EPOC en EPI-SCAN 2" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.L. López-Campos" 1 => "B. Alcázar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2020.10.002" "Revista" => array:3 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2020" "itemHostRev" => array:3 [ "pii" => "S0140673620310977" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia y determinantes de la EPOC en España: EPISCAN II" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.B. Soriano" 1 => "I. Alfageme" 2 => "M. Miravitlles" 3 => "P. de Lucas" 4 => "J.J. Soler-Cataluña" 5 => "F. García-Río" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2020.07.024" "Revista" => array:2 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2020" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nuevo estudio sobre la prevalencia de la EPOC en España: resumen del protocolo EPISCAN II, 10 años después de EPISCAN" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Alfageme" 1 => "P. de Lucas" 2 => "J. Ancochea" 3 => "M. Miravitlles" 4 => "J.J. Soler-Cataluña" 5 => "F. García-Río" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2019" "volumen" => "55" "paginaInicial" => "38" "paginaFinal" => "47" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000003/v1_202103110801/S1579212921000318/v1_202103110801/en/main.assets" "Apartado" => array:4 [ "identificador" => "45358" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000003/v1_202103110801/S1579212921000318/v1_202103110801/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921000318?idApp=UINPBA00003Z" ]
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