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Category Archives: Chronic obstructive

Underdiagnosis of chronic obstructive pulmonary disease: A MATRIX FOR SPIROMETRY SCREENING? (3)

Recently, Chan et al looked at spirometry use in Ontario and reported a rapid increase in its use due to the diffusion of inexpensive spirometers in physicians’ offices and an increased awareness of guidelines promoting objective testing. However, there was …

Underdiagnosis of chronic obstructive pulmonary disease: A MATRIX FOR SPIROMETRY SCREENING? (2)

At the same time, the Lung Health Study does not provide a rationale for mass population screening or even for screening in all smokers. Because it was well known that decreased lung function predictive of COPD can be observed in …

Underdiagnosis of chronic obstructive pulmonary disease: A MATRIX FOR SPIROMETRY SCREENING? (1)

In 1983, the American Thoracic Society issued a position statement discouraging population screening for COPD . There were two main objections. First, it was felt that a positive ‘one-to-one’ correlation between decreased lung function in smokers and future development of …

Underdiagnosis of chronic obstructive pulmonary disease: COPD CLINICAL PROFILE (3)

The Lung Health Study used 35 years of age as its lower limit; this choice was justified by the relatively high proportion of patients aged 35 to 39 years (12%) included in the trial. It is possible, however, that COPD …

Underdiagnosis of chronic obstructive pulmonary disease: COPD CLINICAL PROFILE (2)

The high prevalence of COPD among smokers suggests other possible inclusion criteria for screening, particularly because methacholine reactivity was a strong predictor of decline in lung function in the Lung Health Study . A study by Oxman et al indicated …

Underdiagnosis of chronic obstructive pulmonary disease: COPD CLINICAL PROFILE (1)

The Lung Health Study showed that spirometry screening in a selected population is an effective way to identify individuals at risk for COPD and to initiate effective interventions. Thus, it seems reasonable to conclude that a clinical profile of asymptomatic …

Underdiagnosis of chronic obstructive pulmonary disease: PREDICTIVE ACCURACY OF SPIROMETRY (3)

Health Study, in which over one-third of the participants were women, baseline FEV1 was found to be a significant predictor of subsequent decline in FEV 1 in both male and female continuing smokers . In the same study, interestingly, methacholine …

Underdiagnosis of chronic obstructive pulmonary disease: PREDICTIVE ACCURACY OF SPIROMETRY (2)

The importance of spirometry was demonstrated in a study by van Schayck et al , who evaluated whether the progression of asthma or chronic bronchitis can be predicted by family physicians apart from lung function testing. They compared physical examination …

Underdiagnosis of chronic obstructive pulmonary disease: PREDICTIVE ACCURACY OF SPIROMETRY (1)

Spirometry is objective and quantifiable, and can detect airflow limitation well before symptoms appear. Although patients with confirmed COPD have a low FEV 1 compared with age-adjusted normal values, this measurement alone may not be predictive of COPD . A …

Underdiagnosis of chronic obstructive pulmonary disease: EFFECTIVENESS OF INTERVENTION (3)

The Lung Health Study also showed the benefit of proactive smoking intervention in patients with mild COPD. The sustained quit rate in the special (active) intervention group over five years was 22% compared with only 5% in the usual care …

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