ArticleThorax2014
Exacerbation-like respiratory symptoms in individuals without chronic obstructive pulmonary disease: results from a population-based study.
Article in Thorax, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.
- An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.European respiratory review : an official journal of the European Respiratory Society · 2015Pooled it
- Bronchodilators in Tobacco-Exposed Persons with Symptoms and Preserved Lung Function.The New England journal of medicine · 2022Trial
- Wildfire smoke exposure and persistent respiratory symptoms and illness: a retrospective cohort study.Respiratory research · 2026Article
- Pulmonary vascular features on chest computed tomography differentially associate with adverse outcomes in smokers in COPDGene.Annals of the American Thoracic Society · 2026Article
- Construction and Validation of Active Case-Finding Tool in Community Participants with Chronic Obstructive Pulmonary Disease Using an Interpretable Machine Learning Approach.International journal of chronic obstructive pulmonary disease · 2026Article
- X-ray velocimetry provides temporally and spatially-resolved biomarkers of lung ventilation in small airways disease.Respiratory research · 2025Article
- Lung Function Decline in Smokers with Normal Spirometry: The Devastating Impact of Lung Attacks.American journal of respiratory and critical care medicine · 2025Article
- The Prevalence of Emphysema in Patients Undergoing Lung Cancer Screening in a Middle-Income Country.Diseases (Basel, Switzerland) · 2025Article
- Functionally important respiratory symptoms and continued cigarette use versus e-cigarette switching: population assessment of tobacco and health study waves 2-6.EClinicalMedicine · 2025Article
- Self-report underestimates the frequency of the acute respiratory exacerbations of COPD but is associated with BAL neutrophilia and lymphocytosis: an observational study.BMC pulmonary medicine · 2024Observational
- COPD after "Tabouna" Exposure: A Distinct Phenotype in Tunisian Women?Journal of clinical medicine · 2023Article
- Understanding Early COPD.Respiratory care · 2023Article
- Clinical features and 1-year outcomes of chronic bronchitis in participants with normal spirometry: results from the ECOPD study in China.BMJ open respiratory research · 2023Article
- Chronic Bronchitis Affects Outcomes in Smokers without Chronic Obstructive Pulmonary Disease (COPD).Journal of clinical medicine · 2022Article
- Prognosis of Patients with Chronic Obstructive Pulmonary Disease Not Eligible for Major Clinical Trials.American journal of respiratory and critical care medicine · 2022Article
- Predictors of High Sputum Eosinophils in Chronic Obstructive Pulmonary Disease.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Article
- Journal Club-Respiratory Impairment With A Preserved Spirometric Ratio.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Article
- Defining Resilience to Smoking-related Lung Disease: A Modified Delphi Approach from SPIROMICS.Annals of the American Thoracic Society · 2021Article
- COPD Diagnosis: Time for Disruption.Journal of clinical medicine · 2021Review
- Computed tomography total airway count predicts progression to COPD in at-risk smokers.ERJ open research · 2021Article
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Authors and funding
13 authors at 11 institutions in 2 countries.
Funding
Abstract
rationaleExacerbations of COPD are defined clinically by worsening of chronic respiratory symptoms. Chronic respiratory symptoms are common in the general population. There are no data on the frequency of exacerbation-like events in individuals without spirometric evidence of COPD.
aimsTo determine the occurrence of 'exacerbation-like' events in individuals without airflow limitation, their associated risk factors, healthcare utilisation and social impacts.
methodWe analysed the cross-sectional data from 5176 people aged 40 years and older who participated in a multisite, population-based study on lung health. The study cohort was stratified into spirometrically defined COPD (post-bronchodilator FEV1/FVC < 0.7) and non-COPD (post bronchodilator FEV1/FVC ≥ 0.7 and without self-reported doctor diagnosis of airway diseases) subgroups and then into those with and without respiratory 'exacerbation-like' events in the past year.
resultsIndividuals without COPD had half the frequency of 'exacerbation-like' events compared with those with COPD. In the non-COPD group, the independent associations with 'exacerbations' included female gender, presence of wheezing, the use of respiratory medications and self-perceived poor health. In the non-COPD group, those with exacerbations were more likely than those without exacerbations to have poorer health-related quality of life (12-item Short-Form Health Survey), miss social activities (58.5% vs 18.8%), miss work for income (41.5% vs 17.3%) and miss housework (55.6% vs 16.5%), p<0.01 to <0.0001.
conclusionsEvents similar to exacerbations of COPD can occur in individuals without COPD or asthma and are associated with significant health and socioeconomic outcomes. They increase the respiratory burden in the community and may contribute to the false-positive diagnosis of asthma or COPD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.