This may happen in several clinical scenarios, for example, using the fixed FEV1:FVC ratio in older patients or those cases with non-reversible airflow obstruction at diagnosis that return to normal with treatment or spontaneously over time. Recently, Carter et al7 proposed a theoretical, generic terminology to clearly differentiate within clinical situations regarding inadequate diagnosis. BACKGROUND: The threshold of the lower limit of the normal range of lung function has been suggested to be more accurate than the 0.7 fixed ratio (FEV1/FVC < 0.7) for a diagnosis of COPD. Here, the term over-diagnosis is only meant to refer to correct diagnosis of COPD and may not be associated with increase in morbidity or mortality during their life-time. Contrary to Carter and colleagues proposing ‘too much medicine’ as an umbrella term for overdiagnosis,7 in COPD, however, we believe that the umbrella term should be misdiagnosis itself (Figure 1). Save Recommend Share . ISSN 1553-085X, An Official Publication of the Society of Hospital Medicine, Eosinophilia-guided treatment cuts corticosteroid exposure in COPD exacerbations, COVID-19 may damage blood vessels in the brain, Patients fend for themselves to access highly touted COVID antibody treatments. Synopsis: The Burden of Obstructive Lung Disease (BOLD) study recruited community-dwelling adults who underwent questionnaires, as well as spirometry. Now, researchers have examined the rate of COPD overdiagnosis. Freely submitted; externally peer reviewed. After patients with reported asthma were excluded, 34% of participants with false-positive COPD were found to be treated with respiratory medications as outpatients. Avoiding COPD overdiagnosis starts by obtaining a proper history, including an environmental and occupational exposure history, and a physical examination. BACKGROUND: Although specific guidelines exist for diagnosing COPD on the basis of spirometry testing data (FEV1/FVC < 0.70 or above the lower limit of normal), the literature suggests that overdiagnosis is common. Fourth, COPD is known to be a complex, heterogeneous condition with different disease clinical phenotypes. Copyright by Society of Hospital Medicine or related companies. Community-based population studies conducted in North and South America, Europe, Australia, and Asia collectively suggest that approximately 70% of COPD worldwide may be underdiagnosed. However, they are not synonymous terms, and refer to different situations, with different potential consequences for patients.1 A unified consensus definition is needed for the different clinical scenarios. Concepts, definitions, and actions for misdiagnosis in COPD. Another 8% of patients diagnosed with COPD likely have ACOS as well, based on post-bronchodilator spirometry values and recommended criteria. To prevent the overdiagnosis of chronic obstructive pulmonary disease (COPD) and to help identify individuals who may have asthma or asthma-COPD overlap syndrome (ACOS), clinicians should routinely utilize post-bronchodilator spirometry values in their diagnostic approach, according to new research presented today at the CHEST 2019 Annual Meeting. Accordingly, diagnosis cannot only rely on the simple detection of bronchial obstruction in an appropriate clinical context but must also consider other aspects, the type of COPD and assessment of its severity, to make a comprehensive, full diagnosis.13. With better understanding of the pathogenesis of COPD and the development of new and better diagnostic techniques, the original pink puffer and blue boater phenotypes have been expanded and different clinical presentations are now acknowledged.12 Also, an evaluation of severity should be part of the diagnostic process, in order to guide treatment selection. Among 16,177 patients, 919 (5.7%) reported receiving previous medical diagnoses of COPD; however, spirometry that was performed during the study showed that only 38% of such patients had postbronchodilator FEV 1 /FVC ratios (forced expiratory volume in 1 second:forced vital capacity) lower than the lower limit of normal. Over-diagnosis was defined as those who were labelled as COPD but without the associated symptoms of COPD or evidence of AFO or symptoms of other diseases labelled as COPD. This may include those cases with a compelling clinical context in which it is impossible to perform spirometry, diagnosis based on a pre-bronchodilator spirometry, or those cases where tobacco or other previous exposures are not recorded. Background Mis-diagnosis of COPD was reported to be common in Australia primary care practice. Background: COPD is a highly morbid disease, and there is a need for a better understanding of the true prevalence. 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. Abstract. Overdiagnosis of COPD in subjects with unobstructed spirometry. COPD is a respiratory condition with chronic airway obstruction resulting from the exposure to different inhaled particles or substances, of which tobacco smoke is the major causal factor. Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla. COPD is incurable and affects 900,000 people in the UK, usually above the age of 35, and an estimated 30,000 people die from it each year. 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