Potential clinical implications of targeted spirometry for detection of COPD: A contemporary population-based cohort study
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Potential clinical implications of targeted spirometry for detection of COPD : A contemporary population-based cohort study. / Çolak, Yunus; Nordestgaard, Børge G; Vestbo, Jørgen; Afzal, Shoaib; Lange, Peter.
I: Respiratory Medicine, Bind 197, 106852, 2022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Potential clinical implications of targeted spirometry for detection of COPD
T2 - A contemporary population-based cohort study
AU - Çolak, Yunus
AU - Nordestgaard, Børge G
AU - Vestbo, Jørgen
AU - Afzal, Shoaib
AU - Lange, Peter
N1 - Copyright © 2022 Elsevier Ltd. All rights reserved.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Early diagnosis of chronic obstructive pulmonary disease (COPD) through targeted spirometry may provide better treatment opportunities and in the long run reduce its high burden. We therefore investigated potential beneficial clinical implications of targeted spirometry for detection of COPD and focus on both pulmonary and extrapulmonary conditions in a contemporary general population cohort.METHODS: We recruited 29 678 randomly selected adults from the Copenhagen General Population Study from 2014 to 2017. Individuals unlikely to have undiagnosed COPD with a treatment potential were excluded (age <40 or >80, no smoking or respiratory symptoms, previous COPD/asthma diagnosis). COPD was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.70 and FEV1 <80% of predicted.RESULTS: 5520 (19%) were at high risk of undiagnosed COPD, of whom 589 (11%) fulfilled our COPD criteria. Of these, 45% were smokers, 23% reported modified Medical Research Council dyspnoea scale (mMRC) ≥2, 49% reported COPD assessment test (CAT) ≥10, and 12% reported low physical activity. In addition, 8% were underweight, 28% were obese, 28% had undiagnosed hypertension, 49% had undiagnosed hypercholesterolemia, and 1% had undiagnosed diabetes. When all treatable conditions were considered, only 6.5% of individuals with undiagnosed COPD had no potentially treatable condition, while 73% had at least two treatable conditions.CONCLUSIONS: In a general population setting, one undiagnosed COPD case will be detected for every tenth spirometry in smokers with respiratory symptoms. Up to half of individuals with undiagnosed COPD could potentially benefit from smoking cessation, treatment of respiratory symptoms, increased physical activity, and treatment of other undiagnosed comorbidities.LIMITATION: Post-bronchodilator spirometry was not used to diagnose COPD.
AB - BACKGROUND: Early diagnosis of chronic obstructive pulmonary disease (COPD) through targeted spirometry may provide better treatment opportunities and in the long run reduce its high burden. We therefore investigated potential beneficial clinical implications of targeted spirometry for detection of COPD and focus on both pulmonary and extrapulmonary conditions in a contemporary general population cohort.METHODS: We recruited 29 678 randomly selected adults from the Copenhagen General Population Study from 2014 to 2017. Individuals unlikely to have undiagnosed COPD with a treatment potential were excluded (age <40 or >80, no smoking or respiratory symptoms, previous COPD/asthma diagnosis). COPD was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.70 and FEV1 <80% of predicted.RESULTS: 5520 (19%) were at high risk of undiagnosed COPD, of whom 589 (11%) fulfilled our COPD criteria. Of these, 45% were smokers, 23% reported modified Medical Research Council dyspnoea scale (mMRC) ≥2, 49% reported COPD assessment test (CAT) ≥10, and 12% reported low physical activity. In addition, 8% were underweight, 28% were obese, 28% had undiagnosed hypertension, 49% had undiagnosed hypercholesterolemia, and 1% had undiagnosed diabetes. When all treatable conditions were considered, only 6.5% of individuals with undiagnosed COPD had no potentially treatable condition, while 73% had at least two treatable conditions.CONCLUSIONS: In a general population setting, one undiagnosed COPD case will be detected for every tenth spirometry in smokers with respiratory symptoms. Up to half of individuals with undiagnosed COPD could potentially benefit from smoking cessation, treatment of respiratory symptoms, increased physical activity, and treatment of other undiagnosed comorbidities.LIMITATION: Post-bronchodilator spirometry was not used to diagnose COPD.
KW - Bronchodilator Agents/therapeutic use
KW - Cohort Studies
KW - Forced Expiratory Volume
KW - Humans
KW - Pulmonary Disease, Chronic Obstructive/diagnosis
KW - Spirometry
KW - Vital Capacity
U2 - 10.1016/j.rmed.2022.106852
DO - 10.1016/j.rmed.2022.106852
M3 - Journal article
C2 - 35461169
VL - 197
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
M1 - 106852
ER -
ID: 306437537