TY - JOUR
T1 - Is spirometry properly used to diagnose COPD? results from the BOLD study in salzburg, austria
T2 - A population-based analytical study
AU - Lamprecht, Bernd
AU - Mahringer, Andrea
AU - Soriano, Joan B.
AU - Kaiser, Bernhard
AU - Buist, A. Sonia
AU - Studnicka, Michael
PY - 2013/6
Y1 - 2013/6
N2 - Background: Current guidelines recommend spirometry to confirm a diagnosis of chronic obstructive pulmonary disease (COPD). Aims: To investigate whether a self-reported diagnosis of COPD is associated with prior spirometry and whether a correct diagnosis of COPD is more likely when spirometry was performed. Methods: We used data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD) study. Participants were aged >40 years and completed post-bronchodilator spirometry. Reported COPD diagnosis and reported prior lung function test were based on questionnaire. Persistent airflow limitation was defined as post-bronchodilator forced expiratory volume in one second/forced vital capacity ratio <0.7, corresponding with COPD Global initiative for chronic Obstructive Lung Disease (GOLD) grade I+, and GOLD grade II+ was also investigated. A correct diagnosis of COPD was defined as a reported physician's diagnosis of COPD and the presence of persistent airflow limitation. Results: 68 (5.4%) of 1,258 participants reported a prior physician's diagnosis of COPD. Of these, only 17 (25.0%) reported a lung function test within the past 12 months and 46 (67.6%) at any time in the past. The likelihood for a correct COPD GOLD grade I+ diagnosis was similar among subjects reporting a lung function test during the last 12 months (likelihood ratio 2.07, 95% CI 0.89 to 5.50) and those not reporting a lung function during the last 12 months (likelihood ratio 2.78, 95% CI 1.58 to 4.87). Similar likelihood ratios were seen when GOLD grade II+ was investigated and when lung function was reported at any time in the past. Conclusions: One-third of subjects with a reported diagnosis of COPD never had a lung function test. When spirometry was reported, this did not increase the likelihood of a correct COPD diagnosis.
AB - Background: Current guidelines recommend spirometry to confirm a diagnosis of chronic obstructive pulmonary disease (COPD). Aims: To investigate whether a self-reported diagnosis of COPD is associated with prior spirometry and whether a correct diagnosis of COPD is more likely when spirometry was performed. Methods: We used data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD) study. Participants were aged >40 years and completed post-bronchodilator spirometry. Reported COPD diagnosis and reported prior lung function test were based on questionnaire. Persistent airflow limitation was defined as post-bronchodilator forced expiratory volume in one second/forced vital capacity ratio <0.7, corresponding with COPD Global initiative for chronic Obstructive Lung Disease (GOLD) grade I+, and GOLD grade II+ was also investigated. A correct diagnosis of COPD was defined as a reported physician's diagnosis of COPD and the presence of persistent airflow limitation. Results: 68 (5.4%) of 1,258 participants reported a prior physician's diagnosis of COPD. Of these, only 17 (25.0%) reported a lung function test within the past 12 months and 46 (67.6%) at any time in the past. The likelihood for a correct COPD GOLD grade I+ diagnosis was similar among subjects reporting a lung function test during the last 12 months (likelihood ratio 2.07, 95% CI 0.89 to 5.50) and those not reporting a lung function during the last 12 months (likelihood ratio 2.78, 95% CI 1.58 to 4.87). Similar likelihood ratios were seen when GOLD grade II+ was investigated and when lung function was reported at any time in the past. Conclusions: One-third of subjects with a reported diagnosis of COPD never had a lung function test. When spirometry was reported, this did not increase the likelihood of a correct COPD diagnosis.
KW - Chronic obstructive pulmonary disease
KW - Spirometry
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U2 - 10.4104/pcrj.2013.00032
DO - 10.4104/pcrj.2013.00032
M3 - Article
C2 - 23538703
AN - SCOPUS:84878518580
SN - 1471-4418
VL - 22
SP - 195
EP - 200
JO - Primary Care Respiratory Journal
JF - Primary Care Respiratory Journal
IS - 2
ER -