Survey questionnaire design

Two questionnaires were used in this study. One design included hospital levels, investigating whether their wards had spirometers, types of inhaled bronchodilator medications used, and whether COPD-related health education was provided for patients or not. The other questionnaire aimed at investigating the physicians’ knowledge about COPD and was devised by a pulmonary expert advisory group, which was based on the existing published recommendations of the Chinese COPD guidelines.12 The questionnaire intended to test the COPD knowledge was designed to investigate the demographic information, professional titles, and educational levels of pulmonologists, and to test their knowledge of COPD diagnosis and treatment based on the COPD guidelines. In total, ten single-choice questions were presented including main manifestations of COPD, pathogenesis of COPD, diagnostic criteria, evaluation of pulmonary function, guideline criteria for severity grading, therapy for COPD including pharmacotherapy and oxygen, the common causes of acute exacerbation COPD, and indications for noninvasive ventilation. Every question was worth 10 points. Not answered and wrong answers were given a 0 score. The reliability and validity of the questionnaire had been tested before. Briefly, Cronbach’s alpha score measuring the internal consistency of questions was 0.73 and 0.77 for the first and the second questionnaires, respectively.6

The questionnaires were administered by a research assistant and surveyed anonymously. All pulmonologists participated by completing the questionnaires by themselves.