ArticleBMJ open respiratory research2022
Prevalence and burden of COPD misclassification in the Canadian Longitudinal Study on Aging (CLSA).
Article in BMJ open respiratory research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Prevalence of COPD in other long-term conditions: a systematic meta review.BMC pulmonary medicine · 2026Pooled it
- Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Association between underdiagnosed and overdiagnosed chronic obstructive pulmonary disease with all-cause mortality.Journal of thoracic disease · 2025Article
- Association of triglyceride glucose and obesity indices with chronic obstructive pulmonary disease in US adults: data from 2013 to 2018 NHANES.BMC pulmonary medicine · 2025Article
- A Multi-Specialty Delphi Consensus on Assessing and Managing Cardiopulmonary Risk in Patients with COPD.International journal of chronic obstructive pulmonary disease · 2024Article
- Observational
- 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
- Prevalence of abnormal spirometry in individuals with a smoking history and no known obstructive lung disease.Respiratory medicine · 2023Article
- Data matter: the creation of an acute care surgery registry.Canadian journal of surgery. Journal canadien de chirurgieArticle
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
Abstract
introductionTo examine the prevalence of chronic obstructive pulmonary disease (COPD) misclassification and the associated burden of symptoms, healthcare utilisation and physical performance status in the Canadian general population. This information is presently lacking from large population-based studies with high-quality spirometry data that can be generalised to the general population.
methodsThe prevalence of self-reported physician-diagnosed COPD and the concordance with spirometry airflow obstruction (AO) were assessed in a cross-sectional cohort of Canadian older adults. The associations between confirmed COPD, under-diagnosis and over-diagnosis with self-reported respiratory symptoms, healthcare utilisation and physical performance (timed up and go, handgrip strength and 4 metres walk test) were assessed, adjusting for baseline characteristics using multivariable linear and logistic models.
resultsA total of 21 242 participants (mean age 64 (SD 10) years; 42% men) with high quality spirometry were included. Physician-diagnosed COPD was reported in (n=973) 5% of the participants. Only (n=217) 1% of the entire cohort had confirmed COPD supported by spirometry AO. Discordance between self-reported COPD and spirometry findings was observed in (n=1565) 8%: with 4% representing under-diagnosis cases (no self-reported COPD but AO) and 4% representing over-diagnosis cases (self-reported COPD but no AO). Compared with normals (no self-reported COPD and normal spirometry), those with confirmed, under-diagnosed or over-diagnosed COPD showed higher risks for respiratory symptoms (adjusted OR (aOR) 2.1 (95% CI: 1.6 to 2.7); aOR 1.8 (95% CI: 1.6 to 2.1]; aOR 1.6 (95% CI: 1.4 to 1.9)); healthcare utilisation in the prior 12 months (β coefficient 0.8 (95% CI: 0.2 to 2.6); β 0.9 (95% CI: 0.5 to 1.5); β 1.6 (95% CI: 0.7 to 4.0)). Mood disorders were higher in confirmed and over-diagnosed COPD (aOR 1.7 (95% CI: 1.3 to 2.4); 1.7 (95% CI: 1.4 to 2.0), respectively). Physical performance was lower for COPD groups.
conclusionsThe prevalence of COPD misclassification is high in the general population of older adults. These were associated with significantly high burden of respiratory symptoms, healthcare utilisation and low physical performance compared with the general population with normal spirometry and no self-reported COPD. These findings highlight the high burden of COPD misclassification, which may be substantially reduced with greater accessibility to spirometry measurements in the community.
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