Integrated CT Biomarker Model Boosts COPD Detection in Lung Cancer Screening

Integrated model combining emphysema, Pi10, airway branch count, and clinical data detected undiagnosed COPD with AUC 0.83 (95% CI 0.80-0.86) in 5,014 lung screening participants, up from 0.69 for emphysema alone, reducing confirmatory spirometry referrals from 41% to 34%.

• Prevalence of previously undiagnosed COPD was 22.2% (1,115 of 5,014 participants with available spirometry).
• Using the lower limit of normal definition, the model achieved AUC 0.86 (95% CI 0.83-0.89) with only 22% needing confirmatory spirometry.

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