ArticleInternational journal of chronic obstructive pulmonary disease2017
Overdiagnosis of COPD in hospitalized patients.
Article in International journal of chronic obstructive pulmonary disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluation of common protein biomarkers involved in the pathogenesis of respiratory diseases with proteomic methods: A systematic review.Immunity, inflammation and disease · 2023Pooled it
- Chronic Obstructive Pulmonary Disease Hospitalization in Spain (2016-2023): Mortality Impact of Comorbidity, Sex-Based Disparities and the Impact of COVID-19.Journal of personalized medicine · 2026Article
- Chronic tic cough in adults: a case report.Frontiers in medicine · 2025Article
- A Research Agenda to Improve Outcomes in Patients with Chronic Obstructive Pulmonary Disease and Cardiovascular Disease: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2024Article
- The Increased Burden of Morbidity Over the Life-Course Among Patients with COPD: A Register-Based Cohort Study in Sweden.International journal of chronic obstructive pulmonary disease · 2024Article
- 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
- Midkine-Notch2 Pathway Mediates Excessive Proliferation of Airway Smooth Muscle Cells in Chronic Obstructive Lung Disease.Frontiers in pharmacology · 2022Article
- Article
- MicroRNA-221-3p alleviates cell apoptosis and inflammatory response by targeting cyclin dependent kinase inhibitor 1B in chronic obstructive pulmonary disease.Bioengineered · 2021Article
- Development and Validation of a Method to Estimate COPD Severity in Multiple Datasets: A Retrospective Study.Pulmonary therapy · 2021Article
- Time-ordered comorbidity correlations identify patients at risk of mis- and overdiagnosis.NPJ digital medicine · 2021Article
- GPs should not try to detect mild COPD.NPJ primary care respiratory medicine · 2020Article
- Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD.International journal of chronic obstructive pulmonary disease · 2020Observational
- Active screening for COPD among hospitalized smokers - a feasibility study.Therapeutic advances in chronic disease · 2020Article
- Multimorbidity patterns in patients with heart failure: an observational Spanish study based on electronic health records.BMJ open · 2019Observational
- Use of the terms "overdiagnosis" and "misdiagnosis" in the COPD literature: a rapid review.Breathe (Sheffield, England) · 2019Article
- GLI 2012 equations define few spirometric anomalies in the general population: the PneumoLaus study.Respiratory research · 2018Article
- Agreement between hospital and primary care on diagnostic labeling for COPD and heart failure in Toronto, Canada: a cross-sectional observational study.NPJ primary care respiratory medicine · 2018Observational
- Reliability and usefulness of spirometry performed during admission for COPD exacerbation.PloS one · 2018Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe diagnosis of chronic obstructive pulmonary disease (COPD) is usually made based on history and physical exam alone. Symptoms of dyspnea, cough, and wheeze are nonspecific and attributable to a variety of diseases. Confirmatory testing to verify the airflow obstruction is available but rarely used, which may result in substantial misdiagnoses of COPD. The aim of this study is to evaluate the use of confirmatory testing and assess the accuracy of the diagnosis.
methodsFrom January 2011 through December 2013, 6,018 patients with COPD as a principal or leading diagnosis were admitted at a community teaching hospital. Of those, only 504 (8.4%) patients had spirometry performed during hospitalization. The studies were reviewed by two board-certified pulmonologists to verify presence of persistent airflow obstruction. Charts of these patients were then examined to determine if the spirometry results had changed the diagnosis or the treatment plan for these patients.
resultsSpirometry confirmed the diagnosis of COPD in 270 patients (69.2%) treated as COPD during their hospitalization. Restrictive lung disease was found to be present in 104 patients (26.6%) and normal in 16 patients (4.2%). Factors predictive of airflow obstruction included smoking status and higher pack-year history. Negative predictive factors included higher body mass index (BMI) and other medical comorbidities. These patients were significantly more likely to be misdiagnosed and mistreated as COPD.
conclusionUp to a third of patients diagnosed and treated as COPD in the hospital may be inaccurately diagnosed as COPD based on confirmatory spirometry testing. Factors contributing to the inaccuracy of diagnosis include less smoking history, high BMI, and associated comorbidities.
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