Over diagnosis of chronic obstructive pulmonary disease in an underserved patient population

International Journal of Chronic Obstructive Pulmonary Disease
Christian GhattasMagdi H Awad

Abstract

While cross-national studies have documented rates of chronic obstructive pulmonary disease (COPD) misdiagnosis among patients in primary care, US studies are scarce. Studies investigating diagnosis among uninsured patients are lacking. The purpose of this study is to identify patients who are over diagnosed and thus, mistreated, for COPD in a federally qualified health center. A descriptive study was conducted for a retrospective cohort from February 2011 to June 2012. Spirometry was performed by trained personnel following American Thoracic Society recommendations. Patients were referred for spirometry to confirm previous COPD diagnosis or to assess uncontrolled COPD symptoms. Airway obstruction was defined as a forced expiratory volume in the first second of expiration (FEV1) to forced vital capacity ratio less than 0.7. Reversibility was defined as a postbronchodilator increase in FEV1 greater than 200 mL and greater than 12%. Eighty patients treated for a previous diagnosis of COPD (n = 72) or on anticholinergic inhalers (n = 8) with no COPD diagnosis were evaluated. The average age was 52.9 years; 71% were uninsured. Only 17.5% (14/80) of patients reported previous spirometry. Spirometry revealed that 42.5% had no obstruc...Continue Reading

References

Mar 22, 2003·Respiratory Medicine·M T HalpernR Borker
Sep 23, 2003·BMJ : British Medical Journal·Hannah Jackson, Richard Hubbard
Aug 18, 2004·Lancet·Peter J Barnes, Sabine Kleinert
Mar 15, 2005·Respiratory Medicine·C E BoltonD J Shale
Aug 2, 2005·The European Respiratory Journal·M R MillerATS/ERS Task Force
Sep 15, 2005·JAMA : the Journal of the American Medical Association·Ahmedin JemalMichael Thun
Nov 3, 2005·The European Respiratory Journal·R PellegrinoJ Wanger
Feb 2, 2006·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·David G TinkelmanR J Halbert
Mar 23, 2007·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Lazaros SichletidisDimitros Patakas
Dec 6, 2007·The Journal of Allergy and Clinical Immunology·National Asthma Education and Prevention Program
Feb 10, 2009·Respiratory Medicine·Gabriella Averame"Alliance Project" Study Group
Jun 21, 2011·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Julia A WaltersRichard Wood-Baker
Nov 19, 2011·Respiration; International Review of Thoracic Diseases·Johan BuffelsMarc Decramer
Dec 3, 2011·International Journal of Chronic Obstructive Pulmonary Disease·Hasse MelbyeAnders Ostrem

Citations

May 26, 2012·The Annals of Thoracic Surgery·Michael M MadaniStuart W Jamieson
Nov 23, 2013·Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology·Alexandre Le RouxLorrie Gaschen
Jan 12, 2017·Ciência & saúde coletiva·Ana Teresa Fernandes BarbosaAntônio Prates Caldeira
Mar 7, 2019·Breathe·Terence HoOm P Kurmi
Jul 7, 2018·American Journal of Respiratory and Critical Care Medicine·Nermin DiabShawn D Aaron
Mar 15, 2016·Annals of the American Thoracic Society·Suchit KumbhareCharlie Strange

Related Concepts

Inhalation of Drugs
Broncholytic Effect
Misdiagnosis
Forced Expiratory Volume Function
Lung
National Health Service Corps
Retrospective Studies
Cigar smoker
Spirometry
Vital Capacity

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Pediculosis pubis

Pediculosis pubis is a disease caused by a parasitic insect known as Pthirus pubis, which infests human pubic hair, as well as other areas with hair including eye lashes. Here is the latest research.

Rh Isoimmunization

Rh isoimmunization is a potentially preventable condition that occasionally is associated with significant perinatal morbidity or mortality. Discover the latest research on Rh Isoimmunization here.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells. It also follows CRISPR-Cas9 approaches to generating genetic mutants as a means of understanding the effect of genetics on phenotype.

Enzyme Evolution

This feed focuses on molecular models of enzyme evolution and new approaches (such as adaptive laboratory evolution) to metabolic engineering of microorganisms. Here is the latest research.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Pharmacology of Proteinopathies

This feed focuses on the pharmacology of proteinopathies - diseases in which proteins abnormally aggregate (i.e. Alzheimer’s, Parkinson’s, etc.). Discover the latest research in this field with this feed.

Alignment-free Sequence Analysis Tools

Alignment-free sequence analyses have been applied to problems ranging from whole-genome phylogeny to the classification of protein families, identification of horizontally transferred genes, and detection of recombined sequences. Here is the latest research.