THE EUROPEAN-RESPIRATORY-SOCIETY STUDY ON CHRONIC OBSTRUCTIVE PULMONARY-DISEASE (EUROSCOP) - RECRUITMENT METHODS AND STRATEGIES

The European Respiratory Society's study on chronic obstructive pulmon ary disease (EUROSCOP) is a multicentre study performed initially in 1 2 countries to assess the effect of 3 years' treatment with inhaled co rticosteroids on lung function decline in smokers with chronic obstruc tive pulmonary disease (COPD). It aimed at recruiting 50 subjects in 5 0 European centres. This study discusses the most successful, countryw ise, recruitment strategies, an important issue since many multicentre European studies may follow in the future. The total number of recrui ted subjects was 2147 in 39 participating centres. In total, at least 25 000 screening spirometries were performed, and about 80 000 hospita l records were checked. The most effective way of recruiting subjects was to screen subjects by spirometry after mass media campaigns (eight out of nine countries). Others used workplace screenings and differen t types of population sura ey, and only a few centres successfully rec ruited participants by hospital records. Inclusion criteria were sligh tly changed upon low initial accrual rate. Initial surveys in one coun try, where 2405 subjects were screened by spirometry, gave an importan t indication for the change of the inclusion criteria. Extension of th e upper age limit from 60 to 65 yr considerably improved recruitment, as did a change of the upper limit of FEV1 from below 80% predicted no rmal to below 100% predicted normal, while maintaining the FEV1/VC rat io below 70%. A tremendous effort is needed to recruit individuals wit h preclinical COPD, but this is certainly feasible with adequate strat egies adjusted to each country.