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Validity of physician-diagnosed COPD in relation to spirometric definitions of COPD in a general population aged 50-64 years - the SCAPIS pilot study

Journal article
Authors Kjell Torén
Nicola Murgia
Anna-Carin Olin
Jan A Hedner
John Brandberg
Annika Rosengren
Göran Bergström
Published in International Journal of Chronic Obstructive Pulmonary Disease
Volume 12
Pages 2269-2275
ISSN 1178-2005
Publication year 2017
Published at Institute of Medicine, Department of Public Health and Community Medicine
Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Institute of Medicine
Institute of Medicine, Department of Molecular and Clinical Medicine
Institute of Clinical Sciences, Section for Oncology, Radiation Physics, Radiology and Urology, Department of Radiology
Pages 2269-2275
Language English
Links dx.doi.org/10.2147/copd.s136308
Keywords validity, questionnaire, general-population, obstructive lung diseases, epidemiology, obstructive pulmonary-disease, lung-disease, questionnaires, burden, asthma, risk, misclassification, sample, cohort, bias, Respiratory System
Subject categories Clinical Medicine

Abstract

Background: In epidemiological studies, items about physician-diagnosed COPD are often used. There is a lack of validation and standardization of these items. Materials and methods: In a general population-based study, 1,050 subjects completed a questionnaire and performed spirometry, including forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) after inhalation of 400 mu g of salbutamol. COPD was defined as the ratio of FEV1/FVC < 0.7 after bronchodilation. Physician-diagnosed COPD was defined as an affirmative answer to the single item: "Have you ever had COPD diagnosed by a physician?", physician-diagnosed COPD/emphysema as an affirmative answer to any of the two single items; "Have you ever had COPD diagnosed by a physician?" or "Have you ever been told by a physician that you have emphysema?", physician-diagnosed chronic bronchitis as an affirmative answer to; "Have you ever been told by a physician that you have chronic bronchitis?" and physician-diagnosed COPD, emphysema or chronic bronchitis was defined as an affirmative answer to either of the three items above. Results: For the single item about physician-diagnosed COPD, the sensitivity was around 0.11 and the specificity was almost 0.99 in relation to COPD. The sensitivity of the combined items about COPD/emphysema in detecting COPD was 0.11 and the specificity was high, 0.985. When the items about physician-diagnosed COPD, emphysema or chronic bronchitis were merged as one entity, the sensitivity went up (0.13) and the specificity went down (0.95). Conclusion: Items about physician-diagnosed COPD have low sensitivity but a very high specificity, indicating that these items will minimize the proportion of false positives. The low sensitivity will underestimate the total burden of COPD in the general population. Items about physician-diagnosed COPD may be used in studies of risk factors for COPD, but are not recommended in prevalence studies.

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