ArticleInternational journal of chronic obstructive pulmonary disease2013
Over diagnosis of chronic obstructive pulmonary disease in an underserved patient population.
Article in International journal of chronic obstructive pulmonary disease, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03137303 (Reducing Diagnostic Error to Improve Patient Safety in COPD and Asthma), which is not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Reducing Diagnostic Error to Improve Patient Safety in COPD and Asthma (REDEFINE Study)
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Lung Cancer Risk in US Adults with COPD: A Systematic Review and Meta-Analysis.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Undiagnosed and 'overdiagnosed' COPD using postbronchodilator spirometry in primary healthcare settings: a systematic review and meta-analysis.BMJ open respiratory research · 2023Pooled it
- The effect of a post-bronchodilator FEVRespiratory research · 2025Article
- Chronic Obstructive Pulmonary Disease Overdiagnosis and Overtreatment: A Meta-Analysis.Journal of clinical medicine · 2023Review
- How Accurate Is the Diagnosis of "Chronic Obstructive Pulmonary Disease" in Patients Hospitalized with an Acute Exacerbation?Medicina (Kaunas, Lithuania) · 2023Article
- Article
- Under- and over-diagnosis of COPD: a global perspective.Breathe (Sheffield, England) · 2019Review
- Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic.Healthcare (Basel, Switzerland) · 2018Article
- Inhaled therapies in patients with moderate COPD in clinical practice: current thinking.International journal of chronic obstructive pulmonary disease · 2018Review
- Quality of Chronic Obstructive Pulmonary Disease-Related Health Care in Rural and Urban Veterans Affairs Clinics.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2017Article
- Overdiagnosis of COPD in hospitalized patients.International journal of chronic obstructive pulmonary disease · 2017Article
- Action plans for COPD: strategies to manage exacerbations and improve outcomes.International journal of chronic obstructive pulmonary disease · 2016Review
- The concept of control of COPD in clinical practice.International journal of chronic obstructive pulmonary disease · 2014Article
- Implementation of a targeted screening program to detect airflow obstruction suggestive of chronic obstructive pulmonary disease within a presurgical screening clinic.Canadian respiratory journalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWhile 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.
objectiveThe purpose of this study is to identify patients who are over diagnosed and thus, mistreated, for COPD in a federally qualified health center.
methodsA 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%.
resultsEighty 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 obstruction, 22.5% had reversible obstruction, and 35% had non-reversible obstruction.
conclusionSymptoms and smoking history are insufficient to diagnose COPD. Prevalence of COPD over diagnosis among uninsured patient populations may be higher than previously reported. Confirming previous COPD diagnosis with spirometry is essential to avoid unnecessary and potentially harmful treatment.
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Registered trials
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