Underdiagnosis and Overdiagnosis of Chronic Obstructive Pulmonary Disease

Diab, Nermin; Gershon, Andrea S.; Sin, Don D.; Tan, Wan C.; Bourbeau, Jean; Boulet, Louis‐Philippe; Aaron, Shawn D.

doi:10.1164/rccm.201804-0621ci

Cited by 217 publications

(186 citation statements)

References 52 publications

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“…Moreover, variations in health systems that could result in over-or underdiagnosis of chronic comorbidities such as COPD [20,21] are unaccounted for and may contribute to some of the observed differences between COVID-19 and SPP.…”

Section: Figurementioning

confidence: 99%

Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)

et al. 2020

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Information on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.

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Section: Figurementioning

confidence: 99%

Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)

et al. 2020

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“…The largest contribution of COLD/Can-COLD-related publications may be seen to have advanced knowledge and understanding surrounding appropriate diagnostic approaches and disease characterisation with impact on recommendations for health care services and interventions. More specifically, the larger proportion of studies to date have served to appropriately quantify COPD prevalence and disease determinants 3,4 spirometry testing and prediction equations [5][6][7][8][9] , diagnosis performance and early detection [10][11][12][13][14][15] , novel methods of assessing COPD 16,17 , and COPD clinical impact [18][19][20][21][22] . Consequently, we have elected for this manuscript to summarise key learnings from the CanCOLD study that are relevant to the primary care setting.…”

Section: Resultsmentioning

confidence: 99%

The Canadian Cohort Obstructive Lung Disease (CanCOLD): New Insights for Primary Care Application

Bourbeau¹,

Tan²,

Perrault³

et al. 2021

BRN

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The Canadian Cohort Obstructive Lung disease (CanCOLD) study was launched ten years ago, to provide insight on the natural course of chronic obstructive pulmonary disease (COPD). This project, unique on the world scene for its longitudinal evaluation, is based on random sampling of the population as opposed to more traditional cohorts built on convenience samples of clinical patients. This comprehensive review article has elected to extract and collate from the set of Can-COLD substudies those findings and emerging discoveries that can serve to influence clinical practice, in particular, for primary care. We are presenting findings grouped around three aspects: prevalence of COPD, diagnostic performance, and impacts of COPD. Furthermore, the main results of these studies are supplemented by key messages. From CanCOLD publications we have already learned much, with sufficient substantive data to warrant translation into our clinical practice, guidelines and health policies for the benefit of our COPD patients.

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“…We intentionally studied only patients with known COPD diagnosed by pulmonary function tests, in order to avoid the incorporation of patients over-diagnosed and under-diagnosed of COPD, often present in large clinical databases, which could change the reality of the situation [15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Heart Failure is Highly Prevalent and Difficult to Diagnose in Severe Exacerbations of COPD Presenting to the Emergency Department

Tinè

Bazzan

Semenzato

et al. 2020

JCM

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Background: Some 20% of patients with stable Chronic Obstructive Pulmonary Disease (COPD) might have heart failure (HF). HF contribution to acute exacerbations of COPD (AECOPD) presenting to the emergency department (ED) is not well established. Aims: To assess (1) the HF incidence in patients presenting to the ED with AECOPD; (2) the concordance between ED and respiratory ward (RW) diagnosis; (3) the factors associated with risk of death after hospital discharge. Methods: Retrospective chart review of 119 COPD patients presenting to ED for acute exacerbation of respiratory symptoms and then admitted to RW where a final diagnosis of AECOPD, AECOPD and HF and AECOPD and OD (other diagnosis), was obtained. ED and RW diagnosis were then compared. Factors affecting survival at follow-up were investigated. Results: At RW, 40.3% of cases were diagnosed of AECOPD, 40.3% of AECOPD and HF and 19.4% of AECOPD and OD, with ED diagnosis coinciding with RW’s in 67%, 23%, and 57% of cases respectively. At RW, 60% of patients in GOLD1 had HF, of which 43% were diagnosed at ED, while 40% in GOLD4 had HF that was never diagnosed at ED. Lack of inclusion in a COPD care program, HF, and early readmission for AECOPD were associated with mortality. Conclusions: HF is highly prevalent and difficult to diagnose in patients in all GOLD stages presenting to the ED with severe AECOPD, and along with lack of inclusion in a COPD care program, confers a high risk for mortality.

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Underdiagnosis and Overdiagnosis of Chronic Obstructive Pulmonary Disease

Cited by 217 publications

References 52 publications

Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)

Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)

The Canadian Cohort Obstructive Lung Disease (CanCOLD): New Insights for Primary Care Application

Heart Failure is Highly Prevalent and Difficult to Diagnose in Severe Exacerbations of COPD Presenting to the Emergency Department

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