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Undiagnosed and misdiagnosed chronic obstructive pulmonary disease: Data from the BOLD Australia study


Petrie, K and Toelle, BG and Wood-Baker, R and Maguire, GP and James, AL and Hunter, M and Johns, DP and Marks, GB and George, J and Abramson, MJ, Undiagnosed and misdiagnosed chronic obstructive pulmonary disease: Data from the BOLD Australia study, International Journal of COPD, 16 pp. 467-475. ISSN 1176-9106 (2021) [Refereed Article]


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Copyright 2021 Petrie et al. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0)

DOI: doi:10.2147/COPD.S287172


Purpose: Spirometry is necessary to confirm COPD, but many patients are diagnosed based on clinical presentation and/or chest x-ray. There are also those who do not present to primary care for case finding and remain undiagnosed. We aimed to identify: (a) factors that are associated with undiagnosed COPD; and (b) factors that are associated with a potential misdiagnosis of COPD.

Patients and methods: This analysis used data from the Burden of Obstructive Lung Disease (BOLD), a cross-sectional study of community dwelling adults randomly selected from six study sites, chosen to provide a representative sample of the Australian population (n= 3357). Participants were grouped by COPD diagnostic criteria based on spirometry and self-reported diagnosis. Odds ratios for predictors of undiagnosed and misdiagnosed were estimated using logistic regression.

Results: Of the BOLD Australia sample, 1.8% had confirmed COPD, of whom only half self-reported a diagnosis of COPD. A further 6.9% probably had COPD, but were undiagnosed. The priority target population for case finding of undiagnosed COPD was aged ≥60 years (particularly those ≥75 years), with wheezing, shortness of breath and a body mass index (BMI) <25kg/m2. The priority target population for identifying and reviewing misdiagnosed COPD was aged <60 years, female, with no wheezing and a BMI ≥25kg/m2.

Conclusion: Challenges continue in accurately diagnosing COPD and greater efforts are needed to identify undiagnosed and misdiagnosed individuals to ensure an accurate diagnosis and the initiation of appropriate management in order to reduce the burden of COPD.

Item Details

Item Type:Refereed Article
Keywords:case finding, diagnosis, epidemiology, spirometry
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Wood-Baker, R (Professor Richard Wood-Baker)
UTAS Author:Johns, DP (Associate Professor David Johns)
ID Code:146750
Year Published:2021
Web of Science® Times Cited:3
Deposited By:Medicine
Deposited On:2021-09-24
Last Modified:2021-10-28
Downloads:8 View Download Statistics

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