Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis.
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McBurnie, Mary Ann
Buist, A Sonia
Mannino, David M
Bateman, Eric D
MetadataShow full item record
CitationOverdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis. 2019, 156(2):277-288 Chest
AbstractBACKGROUND: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. METHODS: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7). RESULTS: Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. CONCLUSIONS: False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.
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- Determinants of underdiagnosis of COPD in national and international surveys.
- Authors: Lamprecht B, Soriano JB, Studnicka M, Kaiser B, Vanfleteren LE, Gnatiuc L, Burney P, Miravitlles M, García-Rio F, Akbari K, Ancochea J, Menezes AM, Perez-Padilla R, Montes de Oca M, Torres-Duque CA, Caballero A, González-García M, Buist S, BOLD Collaborative Research Group, the EPI-SCAN Team, the PLATINO Team, and the PREPOCOL Study Group.
- Issue date: 2015 Oct
- [Utility of normality low limit of spirometry in diagnosed COPD patients].
- Authors: Naveiro-Rilo JC, García García S, Flores-Zurutuza L, Carazo Fernández L, Domínguez Fernández C, Palomo García JL
- Issue date: 2017 Sep - Oct
- Misidentification of airflow obstruction: prevalence and clinical significance in an epidemiological study.
- Authors: Pothirat C, Chaiwong W, Phetsuk N, Liwsrisakun C
- Issue date: 2015
- The prevalence of chronic obstructive pulmonary disease in Uppsala, Sweden--the Burden of Obstructive Lung Disease (BOLD) study: cross-sectional population-based study.
- Authors: Danielsson P, Ólafsdóttir IS, Benediktsdóttir B, Gíslason T, Janson C
- Issue date: 2012 Apr
- Vital capacity and COPD: the Swedish CArdioPulmonary bioImage Study (SCAPIS).
- Authors: Torén K, Olin AC, Lindberg A, Vikgren J, Schiöler L, Brandberg J, Johnsson Å, Engström G, Persson HL, Sköld M, Hedner J, Lindberg E, Malinovschi A, Piitulainen E, Wollmer P, Rosengren A, Janson C, Blomberg A, Bergström G
- Issue date: 2016