Overdiagnosis of COPD in subjects with unobstructed spirometry

Detalhes bibliográficos
Autor(a) principal: Sator, Lea
Data de Publicação: 2019
Outros Autores: Horner, Andreas, Studnicka, Michael, Lamprecht, Bernd, Kaiser, Bernhard, McBurnie, Mary Ann, Buist, A. Sonia, Gnatiuc, Luisa, Mannino, David M., Janson, Christer, Bateman, Eric D., Burney, Peter, Zhong, NanShan, Liu, Shengming, Lu, Jiachun, Ran, Pixin, Wang, Dali, Zheng, Jingping, Zhou, Yumin, Kocabaş, Ali, Hancioglu, Attila, Hanta, Ismail, Kuleci, Sedat, Turkyilmaz, Ahmet Sinan, Umut, Sema, Unalan, Turgay, Dawes, Torkil, Bateman, Eric, Jithoo, Anamika, Adams, Desiree, Barnes, Edward, Freeman, Jasper, Hayes, Anton, Hlengwa, Sipho, Johannisen, Christine, Koopman, Mariana, Louw, Innocentia, Ludick, Ina, Olckers, Alta, Ryck, Johanna, Storbeck, Janita, Gislason, Thorarinn, Benedikdtsdottir, Bryndis, Jörundsdottir, Kristin, Gudmundsdottir, Lovisa, Gudmundsdottir, Sigrun, Gundmundsson, Gunnar, Nizankowska-Mogilnicka, Ewa, Frey, Jakub, Harat, Rafal, Mejza, Filip, Nastalek, Pawel, Pajak, Andrzej, Skucha, Wojciech, Szczeklik, Andrzej, Twardowska, Magda, Welte, Tobias, Bodemann, Isabelle, Geldmacher, Henning, Schweda-Linow, Alexandra, Gulsvik, Amund, Endresen, Tina, Svendsen, Lene, Tan, Wan C., Wang, Wen, Cain, John, Copeland, Rebecca, Hazen, Dana, Methvin, Jennifer, Dantes, Renato B., Amarillo, Lourdes, Berratio, Lakan U., Fernandez, Lenora C., Francisco, Norberto A., Garcia, Gerard S., de Guia, Teresita S., Idolor, Luisito F., Naval, Sullian S., Reyes, Thessa, Roa, Camilo C., Sanchez, Ma. Flordeliza, Simpao, Leander P., Jenkins, Christine, Marks, Guy, Bird, Tessa, Espinel, Paola, Hardaker, Kate, Toelle, Brett, Burney, Peter G.J., Amor, Caron, Potts, James, Tumilty, Michael, McLean, Fiona, Wouters, E.F.M., Wesseling, G.J., Bárbara, Cristina, Rodrigues, Fátima, Dias, Hermínia Brites, Cardoso, João, Almeida, João, Matos, Maria João, Simão, Paula, Santos, Moutinho, Ferreira, Reis, Olafsdottir, Inga Sif, Nisser, Katarina, Spetz-Nyström, Ulrike, Hägg, Gunilla, Lund, Gun-Marie, Jõgi, Rain, Laja, Hendrik, Ulst, Katrin, Zobel, Vappu, Lill, Toomas-Julius, Koul, Parvaiz A., Malik, Sajjad, Hakim, Nissar A., Khan, Umar Hafiz, Chowgule, Rohini, Shetye, Vasant, Raphael, Jonelle, Almeda, Rosel, Tawde, Mahesh, Tadvi, Rafiq, Katkar, Sunil, Kadam, Milind, Dhanawade, Rupesh, Ghurup, Umesh, Harrabi, Imed, Denguezli, Myriam, Tabka, Zouhair, Daldoul, Hager, Boukheroufa, Zaki, Chouikha, Firas, Khalifa, Wahbi Belhaj, Ayuyao, Fernando G., Tady, Cecil Z., Tan, Daniel T., Banal-Yang, Sylvia, Balanag, Vincent M., Reyes, Maria Teresita N., Juvekar, Sanjay, Hirve, Siddhi, Sambhudas, Somnath, Chaidhary, Bharat, Tambe, Meera, Pingale, Savita, Umap, Arati, Umap, Archana, Shelar, Nitin, Devchakke, Sampada, Chaudhary, Sharda, Bondre, Suvarna, Walke, Savita, Gawhane, Ashleshsa, Sapkal, Anil, Argade, Rupali, Gaikwad, Vijay, Salvi, Sundeep, Brashier, Bill, Londhe, Jyoti, Madas, Sapna, Obaseki, Daniel, Erhabor, Gregory, Awopeju, Olayemi, Adewole, Olufemi
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.21/14633
Resumo: Background: There are several reports on the 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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spelling Overdiagnosis of COPD in subjects with unobstructed spirometryChronic obstructive pulmonary diseaseCOPDFalse positive diagnosisMisdiagnosisOverdiagnosisOvertreatmentBackground: There are several reports on the 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.RCIPLSator, LeaHorner, AndreasStudnicka, MichaelLamprecht, BerndKaiser, BernhardMcBurnie, Mary AnnBuist, A. SoniaGnatiuc, LuisaMannino, David M.Janson, ChristerBateman, Eric D.Burney, PeterZhong, NanShanLiu, ShengmingLu, JiachunRan, PixinWang, DaliZheng, JingpingZhou, YuminKocabaş, AliHancioglu, AttilaHanta, IsmailKuleci, SedatTurkyilmaz, Ahmet SinanUmut, SemaUnalan, TurgayStudnicka, MichaelDawes, TorkilLamprecht, BerndSator, LeaBateman, EricJithoo, AnamikaAdams, DesireeBarnes, EdwardFreeman, JasperHayes, AntonHlengwa, SiphoJohannisen, ChristineKoopman, MarianaLouw, InnocentiaLudick, InaOlckers, AltaRyck, JohannaStorbeck, JanitaGislason, ThorarinnBenedikdtsdottir, BryndisJörundsdottir, KristinGudmundsdottir, LovisaGudmundsdottir, SigrunGundmundsson, GunnarNizankowska-Mogilnicka, EwaFrey, JakubHarat, RafalMejza, FilipNastalek, PawelPajak, AndrzejSkucha, WojciechSzczeklik, AndrzejTwardowska, MagdaWelte, TobiasBodemann, IsabelleGeldmacher, HenningSchweda-Linow, AlexandraGulsvik, AmundEndresen, TinaSvendsen, LeneTan, Wan C.Wang, WenMannino, David M.Cain, JohnCopeland, RebeccaHazen, DanaMethvin, JenniferDantes, Renato B.Amarillo, LourdesBerratio, Lakan U.Fernandez, Lenora C.Francisco, Norberto A.Garcia, Gerard S.de Guia, Teresita S.Idolor, Luisito F.Naval, Sullian S.Reyes, ThessaRoa, Camilo C.Sanchez, Ma. FlordelizaSimpao, Leander P.Jenkins, ChristineMarks, GuyBird, TessaEspinel, PaolaHardaker, KateToelle, BrettBurney, Peter G.J.Amor, CaronPotts, JamesTumilty, MichaelMcLean, FionaWouters, E.F.M.Wesseling, G.J.Bárbara, CristinaRodrigues, FátimaDias, Hermínia BritesCardoso, JoãoAlmeida, JoãoMatos, Maria JoãoSimão, PaulaSantos, MoutinhoFerreira, ReisJanson, ChristerOlafsdottir, Inga SifNisser, KatarinaSpetz-Nyström, UlrikeHägg, GunillaLund, Gun-MarieJõgi, RainLaja, HendrikUlst, KatrinZobel, VappuLill, Toomas-JuliusKoul, Parvaiz A.Malik, SajjadHakim, Nissar A.Khan, Umar HafizChowgule, RohiniShetye, VasantRaphael, JonelleAlmeda, RoselTawde, MaheshTadvi, RafiqKatkar, SunilKadam, MilindDhanawade, RupeshGhurup, UmeshHarrabi, ImedDenguezli, MyriamTabka, ZouhairDaldoul, HagerBoukheroufa, ZakiChouikha, FirasKhalifa, Wahbi BelhajIdolor, Luisito F.de Guia, Teresita S.Francisco, Norberto A.Roa, Camilo C.Ayuyao, Fernando G.Tady, Cecil Z.Tan, Daniel T.Banal-Yang, SylviaBalanag, Vincent M.Reyes, Maria Teresita N.Dantes, Renato B.Juvekar, SanjayHirve, SiddhiSambhudas, SomnathChaidhary, BharatTambe, MeeraPingale, SavitaUmap, AratiUmap, ArchanaShelar, NitinDevchakke, SampadaChaudhary, ShardaBondre, SuvarnaWalke, SavitaGawhane, AshleshsaSapkal, AnilArgade, RupaliGaikwad, VijaySalvi, SundeepBrashier, BillLondhe, JyotiMadas, SapnaObaseki, DanielErhabor, GregoryAwopeju, OlayemiAdewole, Olufemi2022-08-01T00:30:20Z2019-082019-08-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.21/14633engSator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, BOLD Collaborative Research Group [Dias HB]. Overdiagnosis of COPD in subjects with unobstructed spirometry. Chest. 2019;156(2):277-88.10.1016/j.chest.2019.01.015info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-03T10:11:05Zoai:repositorio.ipl.pt:10400.21/14633Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:22:24.576478Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Overdiagnosis of COPD in subjects with unobstructed spirometry
title Overdiagnosis of COPD in subjects with unobstructed spirometry
spellingShingle Overdiagnosis of COPD in subjects with unobstructed spirometry
Sator, Lea
Chronic obstructive pulmonary disease
COPD
False positive diagnosis
Misdiagnosis
Overdiagnosis
Overtreatment
title_short Overdiagnosis of COPD in subjects with unobstructed spirometry
title_full Overdiagnosis of COPD in subjects with unobstructed spirometry
title_fullStr Overdiagnosis of COPD in subjects with unobstructed spirometry
title_full_unstemmed Overdiagnosis of COPD in subjects with unobstructed spirometry
title_sort Overdiagnosis of COPD in subjects with unobstructed spirometry
author Sator, Lea
author_facet Sator, Lea
Horner, Andreas
Studnicka, Michael
Lamprecht, Bernd
Kaiser, Bernhard
McBurnie, Mary Ann
Buist, A. Sonia
Gnatiuc, Luisa
Mannino, David M.
Janson, Christer
Bateman, Eric D.
Burney, Peter
Zhong, NanShan
Liu, Shengming
Lu, Jiachun
Ran, Pixin
Wang, Dali
Zheng, Jingping
Zhou, Yumin
Kocabaş, Ali
Hancioglu, Attila
Hanta, Ismail
Kuleci, Sedat
Turkyilmaz, Ahmet Sinan
Umut, Sema
Unalan, Turgay
Dawes, Torkil
Bateman, Eric
Jithoo, Anamika
Adams, Desiree
Barnes, Edward
Freeman, Jasper
Hayes, Anton
Hlengwa, Sipho
Johannisen, Christine
Koopman, Mariana
Louw, Innocentia
Ludick, Ina
Olckers, Alta
Ryck, Johanna
Storbeck, Janita
Gislason, Thorarinn
Benedikdtsdottir, Bryndis
Jörundsdottir, Kristin
Gudmundsdottir, Lovisa
Gudmundsdottir, Sigrun
Gundmundsson, Gunnar
Nizankowska-Mogilnicka, Ewa
Frey, Jakub
Harat, Rafal
Mejza, Filip
Nastalek, Pawel
Pajak, Andrzej
Skucha, Wojciech
Szczeklik, Andrzej
Twardowska, Magda
Welte, Tobias
Bodemann, Isabelle
Geldmacher, Henning
Schweda-Linow, Alexandra
Gulsvik, Amund
Endresen, Tina
Svendsen, Lene
Tan, Wan C.
Wang, Wen
Cain, John
Copeland, Rebecca
Hazen, Dana
Methvin, Jennifer
Dantes, Renato B.
Amarillo, Lourdes
Berratio, Lakan U.
Fernandez, Lenora C.
Francisco, Norberto A.
Garcia, Gerard S.
de Guia, Teresita S.
Idolor, Luisito F.
Naval, Sullian S.
Reyes, Thessa
Roa, Camilo C.
Sanchez, Ma. Flordeliza
Simpao, Leander P.
Jenkins, Christine
Marks, Guy
Bird, Tessa
Espinel, Paola
Hardaker, Kate
Toelle, Brett
Burney, Peter G.J.
Amor, Caron
Potts, James
Tumilty, Michael
McLean, Fiona
Wouters, E.F.M.
Wesseling, G.J.
Bárbara, Cristina
Rodrigues, Fátima
Dias, Hermínia Brites
Cardoso, João
Almeida, João
Matos, Maria João
Simão, Paula
Santos, Moutinho
Ferreira, Reis
Olafsdottir, Inga Sif
Nisser, Katarina
Spetz-Nyström, Ulrike
Hägg, Gunilla
Lund, Gun-Marie
Jõgi, Rain
Laja, Hendrik
Ulst, Katrin
Zobel, Vappu
Lill, Toomas-Julius
Koul, Parvaiz A.
Malik, Sajjad
Hakim, Nissar A.
Khan, Umar Hafiz
Chowgule, Rohini
Shetye, Vasant
Raphael, Jonelle
Almeda, Rosel
Tawde, Mahesh
Tadvi, Rafiq
Katkar, Sunil
Kadam, Milind
Dhanawade, Rupesh
Ghurup, Umesh
Harrabi, Imed
Denguezli, Myriam
Tabka, Zouhair
Daldoul, Hager
Boukheroufa, Zaki
Chouikha, Firas
Khalifa, Wahbi Belhaj
Ayuyao, Fernando G.
Tady, Cecil Z.
Tan, Daniel T.
Banal-Yang, Sylvia
Balanag, Vincent M.
Reyes, Maria Teresita N.
Juvekar, Sanjay
Hirve, Siddhi
Sambhudas, Somnath
Chaidhary, Bharat
Tambe, Meera
Pingale, Savita
Umap, Arati
Umap, Archana
Shelar, Nitin
Devchakke, Sampada
Chaudhary, Sharda
Bondre, Suvarna
Walke, Savita
Gawhane, Ashleshsa
Sapkal, Anil
Argade, Rupali
Gaikwad, Vijay
Salvi, Sundeep
Brashier, Bill
Londhe, Jyoti
Madas, Sapna
Obaseki, Daniel
Erhabor, Gregory
Awopeju, Olayemi
Adewole, Olufemi
author_role author
author2 Horner, Andreas
Studnicka, Michael
Lamprecht, Bernd
Kaiser, Bernhard
McBurnie, Mary Ann
Buist, A. Sonia
Gnatiuc, Luisa
Mannino, David M.
Janson, Christer
Bateman, Eric D.
Burney, Peter
Zhong, NanShan
Liu, Shengming
Lu, Jiachun
Ran, Pixin
Wang, Dali
Zheng, Jingping
Zhou, Yumin
Kocabaş, Ali
Hancioglu, Attila
Hanta, Ismail
Kuleci, Sedat
Turkyilmaz, Ahmet Sinan
Umut, Sema
Unalan, Turgay
Dawes, Torkil
Bateman, Eric
Jithoo, Anamika
Adams, Desiree
Barnes, Edward
Freeman, Jasper
Hayes, Anton
Hlengwa, Sipho
Johannisen, Christine
Koopman, Mariana
Louw, Innocentia
Ludick, Ina
Olckers, Alta
Ryck, Johanna
Storbeck, Janita
Gislason, Thorarinn
Benedikdtsdottir, Bryndis
Jörundsdottir, Kristin
Gudmundsdottir, Lovisa
Gudmundsdottir, Sigrun
Gundmundsson, Gunnar
Nizankowska-Mogilnicka, Ewa
Frey, Jakub
Harat, Rafal
Mejza, Filip
Nastalek, Pawel
Pajak, Andrzej
Skucha, Wojciech
Szczeklik, Andrzej
Twardowska, Magda
Welte, Tobias
Bodemann, Isabelle
Geldmacher, Henning
Schweda-Linow, Alexandra
Gulsvik, Amund
Endresen, Tina
Svendsen, Lene
Tan, Wan C.
Wang, Wen
Cain, John
Copeland, Rebecca
Hazen, Dana
Methvin, Jennifer
Dantes, Renato B.
Amarillo, Lourdes
Berratio, Lakan U.
Fernandez, Lenora C.
Francisco, Norberto A.
Garcia, Gerard S.
de Guia, Teresita S.
Idolor, Luisito F.
Naval, Sullian S.
Reyes, Thessa
Roa, Camilo C.
Sanchez, Ma. Flordeliza
Simpao, Leander P.
Jenkins, Christine
Marks, Guy
Bird, Tessa
Espinel, Paola
Hardaker, Kate
Toelle, Brett
Burney, Peter G.J.
Amor, Caron
Potts, James
Tumilty, Michael
McLean, Fiona
Wouters, E.F.M.
Wesseling, G.J.
Bárbara, Cristina
Rodrigues, Fátima
Dias, Hermínia Brites
Cardoso, João
Almeida, João
Matos, Maria João
Simão, Paula
Santos, Moutinho
Ferreira, Reis
Olafsdottir, Inga Sif
Nisser, Katarina
Spetz-Nyström, Ulrike
Hägg, Gunilla
Lund, Gun-Marie
Jõgi, Rain
Laja, Hendrik
Ulst, Katrin
Zobel, Vappu
Lill, Toomas-Julius
Koul, Parvaiz A.
Malik, Sajjad
Hakim, Nissar A.
Khan, Umar Hafiz
Chowgule, Rohini
Shetye, Vasant
Raphael, Jonelle
Almeda, Rosel
Tawde, Mahesh
Tadvi, Rafiq
Katkar, Sunil
Kadam, Milind
Dhanawade, Rupesh
Ghurup, Umesh
Harrabi, Imed
Denguezli, Myriam
Tabka, Zouhair
Daldoul, Hager
Boukheroufa, Zaki
Chouikha, Firas
Khalifa, Wahbi Belhaj
Ayuyao, Fernando G.
Tady, Cecil Z.
Tan, Daniel T.
Banal-Yang, Sylvia
Balanag, Vincent M.
Reyes, Maria Teresita N.
Juvekar, Sanjay
Hirve, Siddhi
Sambhudas, Somnath
Chaidhary, Bharat
Tambe, Meera
Pingale, Savita
Umap, Arati
Umap, Archana
Shelar, Nitin
Devchakke, Sampada
Chaudhary, Sharda
Bondre, Suvarna
Walke, Savita
Gawhane, Ashleshsa
Sapkal, Anil
Argade, Rupali
Gaikwad, Vijay
Salvi, Sundeep
Brashier, Bill
Londhe, Jyoti
Madas, Sapna
Obaseki, Daniel
Erhabor, Gregory
Awopeju, Olayemi
Adewole, Olufemi
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dc.contributor.none.fl_str_mv RCIPL
dc.contributor.author.fl_str_mv Sator, Lea
Horner, Andreas
Studnicka, Michael
Lamprecht, Bernd
Kaiser, Bernhard
McBurnie, Mary Ann
Buist, A. Sonia
Gnatiuc, Luisa
Mannino, David M.
Janson, Christer
Bateman, Eric D.
Burney, Peter
Zhong, NanShan
Liu, Shengming
Lu, Jiachun
Ran, Pixin
Wang, Dali
Zheng, Jingping
Zhou, Yumin
Kocabaş, Ali
Hancioglu, Attila
Hanta, Ismail
Kuleci, Sedat
Turkyilmaz, Ahmet Sinan
Umut, Sema
Unalan, Turgay
Studnicka, Michael
Dawes, Torkil
Lamprecht, Bernd
Sator, Lea
Bateman, Eric
Jithoo, Anamika
Adams, Desiree
Barnes, Edward
Freeman, Jasper
Hayes, Anton
Hlengwa, Sipho
Johannisen, Christine
Koopman, Mariana
Louw, Innocentia
Ludick, Ina
Olckers, Alta
Ryck, Johanna
Storbeck, Janita
Gislason, Thorarinn
Benedikdtsdottir, Bryndis
Jörundsdottir, Kristin
Gudmundsdottir, Lovisa
Gudmundsdottir, Sigrun
Gundmundsson, Gunnar
Nizankowska-Mogilnicka, Ewa
Frey, Jakub
Harat, Rafal
Mejza, Filip
Nastalek, Pawel
Pajak, Andrzej
Skucha, Wojciech
Szczeklik, Andrzej
Twardowska, Magda
Welte, Tobias
Bodemann, Isabelle
Geldmacher, Henning
Schweda-Linow, Alexandra
Gulsvik, Amund
Endresen, Tina
Svendsen, Lene
Tan, Wan C.
Wang, Wen
Mannino, David M.
Cain, John
Copeland, Rebecca
Hazen, Dana
Methvin, Jennifer
Dantes, Renato B.
Amarillo, Lourdes
Berratio, Lakan U.
Fernandez, Lenora C.
Francisco, Norberto A.
Garcia, Gerard S.
de Guia, Teresita S.
Idolor, Luisito F.
Naval, Sullian S.
Reyes, Thessa
Roa, Camilo C.
Sanchez, Ma. Flordeliza
Simpao, Leander P.
Jenkins, Christine
Marks, Guy
Bird, Tessa
Espinel, Paola
Hardaker, Kate
Toelle, Brett
Burney, Peter G.J.
Amor, Caron
Potts, James
Tumilty, Michael
McLean, Fiona
Wouters, E.F.M.
Wesseling, G.J.
Bárbara, Cristina
Rodrigues, Fátima
Dias, Hermínia Brites
Cardoso, João
Almeida, João
Matos, Maria João
Simão, Paula
Santos, Moutinho
Ferreira, Reis
Janson, Christer
Olafsdottir, Inga Sif
Nisser, Katarina
Spetz-Nyström, Ulrike
Hägg, Gunilla
Lund, Gun-Marie
Jõgi, Rain
Laja, Hendrik
Ulst, Katrin
Zobel, Vappu
Lill, Toomas-Julius
Koul, Parvaiz A.
Malik, Sajjad
Hakim, Nissar A.
Khan, Umar Hafiz
Chowgule, Rohini
Shetye, Vasant
Raphael, Jonelle
Almeda, Rosel
Tawde, Mahesh
Tadvi, Rafiq
Katkar, Sunil
Kadam, Milind
Dhanawade, Rupesh
Ghurup, Umesh
Harrabi, Imed
Denguezli, Myriam
Tabka, Zouhair
Daldoul, Hager
Boukheroufa, Zaki
Chouikha, Firas
Khalifa, Wahbi Belhaj
Idolor, Luisito F.
de Guia, Teresita S.
Francisco, Norberto A.
Roa, Camilo C.
Ayuyao, Fernando G.
Tady, Cecil Z.
Tan, Daniel T.
Banal-Yang, Sylvia
Balanag, Vincent M.
Reyes, Maria Teresita N.
Dantes, Renato B.
Juvekar, Sanjay
Hirve, Siddhi
Sambhudas, Somnath
Chaidhary, Bharat
Tambe, Meera
Pingale, Savita
Umap, Arati
Umap, Archana
Shelar, Nitin
Devchakke, Sampada
Chaudhary, Sharda
Bondre, Suvarna
Walke, Savita
Gawhane, Ashleshsa
Sapkal, Anil
Argade, Rupali
Gaikwad, Vijay
Salvi, Sundeep
Brashier, Bill
Londhe, Jyoti
Madas, Sapna
Obaseki, Daniel
Erhabor, Gregory
Awopeju, Olayemi
Adewole, Olufemi
dc.subject.por.fl_str_mv Chronic obstructive pulmonary disease
COPD
False positive diagnosis
Misdiagnosis
Overdiagnosis
Overtreatment
topic Chronic obstructive pulmonary disease
COPD
False positive diagnosis
Misdiagnosis
Overdiagnosis
Overtreatment
description Background: There are several reports on the 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.
publishDate 2019
dc.date.none.fl_str_mv 2019-08
2019-08-01T00:00:00Z
2022-08-01T00:30:20Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.21/14633
url http://hdl.handle.net/10400.21/14633
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Sator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, BOLD Collaborative Research Group [Dias HB]. Overdiagnosis of COPD in subjects with unobstructed spirometry. Chest. 2019;156(2):277-88.
10.1016/j.chest.2019.01.015
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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