ArticleChest2014
The association of weight with the detection of airflow obstruction and inhaled treatment among patients with a clinical diagnosis of COPD.
Article in Chest, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 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
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Long-Term Noninvasive Ventilation in Chronic Stable Hypercapnic Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2020Guideline
- Association Between Monocyte-to-High Density Lipoprotein-Cholesterol Ratio and COPD Among US Adults: Findings from NHANES 1999-2018.International journal of chronic obstructive pulmonary disease · 2026Article
- The effect of a post-bronchodilator FEVRespiratory research · 2025Article
- The Role of Obstructive Sleep Apnea in Hypercapnic Respiratory Failure Identified in Critical Care, Inpatient, and Outpatient Settings.Sleep medicine clinics · 2024Review
- The prevalence and mortality risks of PRISm and COPD in the United States from NHANES 2007-2012.Respiratory research · 2024Article
- Chronic Obstructive Pulmonary Disease Overdiagnosis and Overtreatment: A Meta-Analysis.Journal of clinical medicine · 2023Review
- Adipocyte dysfunction promotes lung inflammation and aberrant repair: a potential target of COPD.Frontiers in endocrinology · 2023Article
- Treatable Traits in Misdiagnosed Chronic Obstructive Pulmonary Disease: Data from the Akershus Cardiac Examination 1950 Study.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Article
- Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study.Healthcare (Basel, Switzerland) · 2021Article
- Inhaled Medication Use in Smokers With Normal Spirometry.Respiratory care · 2021Article
- Overuse and Misuse of Inhaled Corticosteroids Among Veterans with COPD: a Cross-sectional Study Evaluating Targets for De-implementation.Journal of general internal medicine · 2020Article
- De-implementing Inhaled Corticosteroids to Improve Care and Safety in COPD Treatment: Primary Care Providers' Perspectives.Journal of general internal medicine · 2020Article
- COPD overdiagnosis in primary care: a UK observational study of consistency of airflow obstruction.NPJ primary care respiratory medicine · 2019Observational
- Under- and over-diagnosis of COPD: a global perspective.Breathe (Sheffield, England) · 2019Review
- Role of Comorbidities in Treatment and Outcomes after Chronic Obstructive Pulmonary Disease Exacerbations.Annals of the American Thoracic Society · 2018Article
- How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: A preliminary model of unlearning and substitution.Journal of evaluation in clinical practice · 2018Article
- Lung cancer and chronic obstructive pulmonary disease: From a clinical perspective.Oncotarget · 2017Review
- Overdiagnosis of COPD in hospitalized patients.International journal of chronic obstructive pulmonary disease · 2017Article
- Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes.Journal of general internal medicine · 2016Article
- The clinical characteristics and hospital and post-hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort.Obesity science & practice · 2016Article
Corrections and comments
- Commented on by
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMost patients with a clinical diagnosis of COPD have not had spirometry to confirm airflow obstruction (AFO). Overweight and obese patients report more dyspnea than normal weight patients, which may be falsely attributed to AFO. We sought to determine whether overweight and obese patients who received a clinical diagnosis of COPD were more likely to receive a misdiagnosis (ie, lack of AFO on spirometry) and be subsequently treated with inhaled medications.
methodsThe cohort comprised US veterans with COPD (International Classification of Diseases, 9th Revision, code; inhaled medication use; or both) and spirometry measurements from one of three Pacific Northwest Veterans Administration Medical Centers. The measured exposures were overweight and obesity (defined by BMI categories). Outcomes were (1) AFO on spirometry and (2) escalation or deescalation of inhaled therapies from 3 months before spirometry to 9 to 12 months after spirometry. We used multivariable logistic regression with calculation of adjusted proportions for all analyses.
resultsFifty-two percent of 5,493 veterans who had received a clinical diagnosis of COPD had AFO. The adjusted proportion of patients with AFO decreased as BMI increased (P < .01 for trend). Among patients without AFO, those who were overweight and obese were less likely to remain off medications or to have therapy deescalated (adjusted proportions: normal weight, 0.69 [95% CI, 0.64-0.73]; overweight, 0.62 [95% CI, 0.58-0.65; P = .014]; obese, 0.60 [95% CI, 0.57-0.63; P = .001]).
conclusionsOverweight and obese patients are more likely to be given a misdiagnosis of COPD and not have their inhaled medications deescalated after spirometry demonstrated no AFO. Providers may be missing potential opportunities to recognize and treat other causes of dyspnea in these patients.
Indexed as
Identifiers
What OpenQuestion holds
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.