RT Journal Article
SR Electronic
T1 Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1117
OP 1122
DO 10.1183/09031936.02.00023202
VO 20
IS 5
A1 Hardie, J.A.
A1 Buist, A.S.
A1 Vollmer, W.M.
A1 Ellingsen, I.
A1 Bakke, P.S.
A1 Mørkve, O.
YR 2002
UL http://erj.ersjournals.com/content/20/5/1117.abstract
AB The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has defined stage 1 chronic obstructive pulmonary disease (COPD) as forced expiratory volume in one second/forced vital capacity (FEV1/FVC)% <70% and a FEV1% predicted of >80%. Stage 2 has been defined as FEV1/FVC <70% and a FEV1% pred of <80%. The authors examined the extent of COPD misdiagnosis using this definition in healthy, never-smoker, asymptomatic adults aged >70 yrs in Bergen, Norway. A respiratory questionnaire was mailed to a random sample of 2,871 persons aged>70 yrs. In a random, well-defined subgroup of 208 never-smoker respondents with no current respiratory disease and significant dyspnoea or heart disease/hypertension complicated with dyspnoea, 71 were able to perform an acceptable spirometry. Approximately 35% of these healthy, elderly never-smokers had an FEV1/FVC% of <70% and would be classified as having at least a stage 1 COPD. This percentage increased with age and in those aged >80 yrs ∼50% would be classified as having COPD and approximately one-third would have an FEV1 of <80% pred (stage 2 COPD). The estimated 5th percentile of FEV1 was consistently <80% pred. The Global Initiative for Chronic Obstructive Lung Disease criteria will probably lead to a significant degree of over-diagnosis of chronic obstructive pulmonary disease in those aged >70 yrs. The criteria used to define the various stages of chronic obstructive pulmonary disease need to be age-specific. This study was supported by the University of Bergen (Bergen, Norway), Nasjonalforeningen for folkehelse (Oslo, Norway) and GlaxoSmithKline (Oslo, Norway).