- Overdiagnosis of COPD is common.
- Symptom-based diagnosis without spirometry risks exposing patients to unnecessary medication.
- Authors: “Health care professionals are either not aware of COPD guidelines or do not use them for their decision-making.”
Why this matters
- Of 919 reporting COPD diagnosis, 61.9% (569) had unobstructed postbronchodilator spirometry, meaning they did not have COPD.
- False-positive rate was 55.3% using fixed-ratio criterion (FEV1/FVC
- Among false-positives:
- 45.7% were using respiratory medication, most often inhaled corticosteroids.
- 34.4% of those without asthma were using respiratory medication.
- False-positive rates in high- vs low-income countries: 4.9% vs 1.9%.
- Predictors of overdiagnosis included female sex, higher education, current or former smoking, respiratory symptoms, comorbid asthma, or heart disease.
- False-negatives: 10.2%.
- Analysis of multinational population-based cross-sectional BOLD study, 2003-2012 (n=16,177).
- After face-to-face interview, participants underwent pre- and postbronchodilator spirometry.
- Outcome: rate of false-positive COPD, defined as patient reporting doctor’s diagnosis of COPD, chronic bronchitis, or emphysema but lacking unobstructed postbronchodilator spirometry (FEV1/FVC
- Funding: The Wellcome Trust; multiple industry, academic sources.
- Self-report might overestimate diagnosis.