, ,

Wait and Retest for COPD?

August 2, 2017 at 3:08 pm

By Jadwiga A. Wedzicha, MD, editor, American Journal of Respiratory and Critical Care Medicine

Follow Dr. Wedzicha on Twitter @ATSBlueEditor

Diagnostic Instability and Reversals of Chronic Obstructive Pulmonary Disease Diagnosis in Individuals with Mild to Moderate Airflow Obstruction

Does a single post-bronchodilator spirometry assessment definitely diagnose COPD in patients with mild to moderate airway obstruction?  Probably not, according to a study published in the Aug. 1 American Journal of Respiratory and Critical Care Medicine that looked at more than 7,000 participants in two study groups. Shawn D. Aaron and colleagues found that over four to five years, diagnostic instability (a positive or negative diagnosis that switches and then reverts to the original diagnosis) was as high as 19.5 percent and diagnostic reversal was as high as 27.2 percent in patients with mild to moderate airway obstruction. As might be expected, patients closest to the diagnostic threshold were most likely to experience diagnostic instability, while patients who quit smoking were most likely to experience a diagnostic reversal.

Noting that COPD guidelines “are silent on the merits of postponing” a COPD diagnosis, the authors say their finding suggest that taking a “wait and retest” approach with patients close to the diagnostic thresholds may avoid the over-diagnosis and under-diagnosis of COPD.

 

AJRCCM Highlights

Aug. 1

Role for NLRP3 Inflammasome-mediated, IL-1β-dependent Responses in Severe, Steroid-Resistant Asthma

Early Expansion of Circulating Granulocytic Myeloid-derived Suppressor Cells Predicts Development of Nosocomial Infections in Septic Patients

Smoking-dependent Distal-to-Proximal Repatterning of the Adult Human Small Airway Epithelium

Antenatal Determinants of Bronchopulmonary Dysplasia and Late Respiratory Disease in Preterm Infants

Aug. 15

Application of a Natural Language Processing Algorithm to Asthma Ascertainment: An Automated Chart Review

FULFIL Trial: Once-Daily Triple Therapy in Patients with Chronic Obstructive Pulmonary Disease

The Host Response in Sepsis Patients Developing Intensive Care Unit–acquired Secondary Infections

Phenotypes of Rapid Cystic Fibrosis Lung Disease Progression during Adolescence and Young Adulthood

A Functional TOLLIP Variant Is Associated with BCG-Specific Immune Responses and Tuberculosis

 

More from ATS Journals

What’s New in the AJRCMB

What’s New in the AnnalsATS

 

Advertisement

ATS 2016 Full Registration