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Diagnosis and early detection of COPD using spirometry


Johns, DP and Walters, JAE and Walters, EH, Diagnosis and early detection of COPD using spirometry, Journal of Thoracic Disease, 6, (11) pp. 1557-1569. ISSN 2072-1439 (2014) [Refereed Article]

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Copyright 2014 Pioneer Bioscience Publishing Company.

DOI: doi:10.3978/j.issn.2072-1439.2014.08.18


The standard respiratory function test for case detection of chronic obstructive pulmonary disease (COPD) is spirometry. The criterion for diagnosis defined in guidelines is based on the FEV1/ FVC ratio forced expiratory ratio (FER) and its severity is based on forced expiratory volume in one second (FEV1) from measurements obtained during maximal forced expiratory manoeuvres. Spirometry is a safe and practical procedure, and when conducted by a trained operator using a spirometer that provides quality feedback, the majority of patients can be coached to provide acceptable and repeatable results. This allows potentially wide application of testing to improve recognition and diagnosis of COPD, such as for case finding in primary care. However, COPD remains substantially under diagnosed in primary care and a major reason for this is underuse of spirometry. The presence of symptoms is not a reliable indicator of disease and diagnosis is often delayed until more severe airflow obstruction is present. Early diagnosis is worthwhile, as it allows risk factors for COPD such as smoking to be addressed promptly and treatment optimised. Paradoxically, investigation of the patho-physiology in COPD has shown that extensive small airway disease exists before it is detectable with conventional spirometric indices, and methods to detect airway disease earlier using the flow-volume curve are discussed.

Item Details

Item Type:Refereed Article
Keywords:spirometry, chronic obstructive pulmonary disease (COPD), case finding, flow-volume curve
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:Clinical health not elsewhere classified
UTAS Author:Johns, DP (Associate Professor David Johns)
UTAS Author:Walters, JAE (Dr Julia Walters)
UTAS Author:Walters, EH (Professor Haydn Walters)
ID Code:97361
Year Published:2014
Funding Support:National Health and Medical Research Council (1001062)
Web of Science® Times Cited:68
Deposited By:Medicine
Deposited On:2014-12-12
Last Modified:2017-11-03

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