Imperial College London
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Professor Peter GJ Burney MA MD FRCP FFPHM FMedSci

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Respiratory Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 7941p.burney

 
 
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Location

 

07Emmanuel Kaye BuildingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sator:2019:10.1016/j.chest.2019.01.015,
author = {Sator, L and Horner, A and Studnicka, M and Lamprecht, B and Kaiser, B and McBurnie, MA and Buist, AS and Gnatiuc, L and Mannino, DM and Janson, C and Bateman, ED and Burney, P and BOLD, Collaborative Research Group},
doi = {10.1016/j.chest.2019.01.015},
journal = {Chest},
pages = {277--288},
title = {Overdiagnosis of COPD in subjects with unobstructed spirometry: a BOLD analysis},
url = {http://dx.doi.org/10.1016/j.chest.2019.01.015},
volume = {156},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: 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.
AU  - Sator,L
AU  - Horner,A
AU  - Studnicka,M
AU  - Lamprecht,B
AU  - Kaiser,B
AU  - McBurnie,MA
AU  - Buist,AS
AU  - Gnatiuc,L
AU  - Mannino,DM
AU  - Janson,C
AU  - Bateman,ED
AU  - Burney,P
AU  - BOLD,Collaborative Research Group
DO  - 10.1016/j.chest.2019.01.015
EP  - 288
PY  - 2019///
SN  - 0012-3692
SP  - 277
TI  - Overdiagnosis of COPD in subjects with unobstructed spirometry: a BOLD analysis
T2  - Chest
UR  - http://dx.doi.org/10.1016/j.chest.2019.01.015
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30711480
UR  - https://www.sciencedirect.com/science/article/pii/S0012369219300662?via%3Dihub
UR  - http://hdl.handle.net/10044/1/68548
VL  - 156
ER  -
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