Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Arabic COPD Population Screener (A-COPD-PS)

Background: Chronic obstructive pulmonary disease (COPD) remains underdiagnosed globally, particularly in regions with limited access to spirometry. The COPD Population Screener (COPD-PS) is a brief questionnaire designed to identify individuals at risk. Objective: This study aimed to translate, culturally adapt, and validate an Arabic version of the COPD-PS (A-COPD-PS). Methods: A prospective validation study was conducted among 196 Arabic-speaking adults recruited from pulmonology outpatient clinics in Saudi Arabia using a convenience sampling approach. The COPD-PS was translated using forward-backward methodology and expert review. Participants completed the A-COPD-PS, COPD Assessment Test (CAT), and Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), followed by spirometry. Criterion validity was assessed using Cohen’s κ, sensitivity, specificity, and receiver operating characteristic (ROC) analysis. Construct validity was evaluated through correlations with CAT and FACIT-F. Reliability was assessed using Cronbach’s α and intraclass correlation coefficients (ICC). Results: The A-COPD-PS demonstrated moderate agreement with spirometry (κ = 0.50, 95% CI: 0.33–0.67), with sensitivity of 50% and specificity of 95%. Scores correlated strongly with CAT (ρ = 0.71, p < 0.001) and moderately with FACIT-F (r = 0.61, p < 0.001). The instrument showed excellent internal consistency (Cronbach’s α = 0.979) and test–retest reliability (n=193) (ICC = 0.975, 95% CI: 0.94–0.99). Conclusion: The A-COPD-PS demonstrates acceptable validity and excellent reliability as a screening tool for COPD risk among Arabic-speaking adults. However, its modest sensitivity suggests it should be used to identify individuals requiring further diagnostic evaluation rather than as a standalone diagnostic instrument.