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Underdiagnosis and misclassification of COPD in Sweden
Department of Care Science, Faculty of Health and Society, Malmö University, Malmö. Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Luleå University of Technology, Department of Health Sciences, Nursing and Medical technology. Dept of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN unit, Umeå .ORCID iD: 0000-0002-0553-8067
Centre for COPD Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Luleå University of Technology, Department of Health Sciences, Nursing Care.ORCID iD: 0000-0001-6622-3838
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2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56, no Suppl 64, article id 1395Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: The prevalence of COPD seems to have leveled or decreased in some high income countries. Worldwide, population studies using spirometry have found substantial underdiagnosis of COPD.

Aim: To investigate underdiagnosis and misclassification of COPD in Sweden.

Methods: A randomly selected sample (n=1839; age 21-78 years; women 52.6%) was derived from two large scale population studies in Sweden, the West Sweden Asthma Study (WSAS) and the Obstructive Lung Disease in Northern Sweden (OLIN) Studies. Examinations including spirometry and structured interviews were conducted 2009-2012. COPD was defined following GOLD 2017: post-bronchodilator FEV1/FVC<0.70 and presence of respiratory symptoms. The subjects were asked if prior to the study they had been diagnosed with COPD, chronic bronchitis, emphysema, asthma, and if they used medicines for airway diseases.

Results: Of those with COPD (GOLD) identified at the clinical examinations, 24% had, prior to the study, been diagnosed with COPD, emphysema, or chronic bronchitis (COPD-cluster), while 46% had been diagnosed with the COPD-cluster, asthma, or used medicines for airway disease (any OAD). The corresponding figures for those fulfilling the criteria of COPD GOLD grade ≥2 were 39% (COPD-cluster) and 62% (any OAD). Among the subjects who, prior to the study, had been diagnosed with COPD, 78% fulfilled the criteria of COPD, but among those who had been diagnosed as having any of the diseases in the COPD-cluster, 31% fulfilled the criteria of COPD.

Conclusion: The proportion of underdiagnosis of COPD is still large in Sweden. Some misclassification of COPD was also found. The results reflect underuse of spirometry in primary care.

Place, publisher, year, edition, pages
European Respiratory Society (ERS) , 2020. Vol. 56, no Suppl 64, article id 1395
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Nursing
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Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-82896DOI: 10.1183/13993003.congress-2020.1395ISI: 000606501402361OAI: oai:DiVA.org:ltu-82896DiVA, id: diva2:1527625
Conference
ERS International Congress, 6-9 September, 2020, Virtual
Note

Godkänd;2021;Nivå 0;2021-02-11 (alebob)

Available from: 2021-02-11 Created: 2021-02-11 Last updated: 2022-11-16Bibliographically approved

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Backman, HelenaStridsman, Caroline

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