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. 2023 Jun 2;33(1):23.
doi: 10.1038/s41533-023-00345-8.

Diagnostic spirometry in COPD is increasing, a comparison of two Swedish cohorts

Åsa Athlin  1 , Karin Lisspers  2 , Mikael Hasselgren  3   4 , Björn Ställberg  2 , Christer Janson  5 , Scott Montgomery  6   7   8 , Maaike Giezeman  3   4 , Marta Kisiel  9 , Anna Nager  10 , Hanna Sandelowsky  7   10   11 , Mats Arne  4   5 , Josefin Sundh  12
Affiliations

Diagnostic spirometry in COPD is increasing, a comparison of two Swedish cohorts

Åsa Athlin et al. NPJ Prim Care Respir Med. .

Abstract

Spirometry should be used to confirm a diagnosis of chronic obstructive pulmonary disease (COPD). This test is not always performed, leading to possible misdiagnosis. We investigated whether the proportion of patients with diagnostic spirometry has increased over time as well as factors associated with omitted or incorrectly interpreted spirometry. Data from medical reviews and a questionnaire from primary and secondary care patients with a doctors' diagnosis of COPD between 2004 and 2010 were collected. Data were compared with a COPD cohort diagnosed between 2000 and 2003. Among 703 patients with a first diagnosis of COPD between 2004 and 2010, 88% had a diagnostic spirometry, compared with 59% (p < 0.001) in the previous cohort. Factors associated with not having diagnostic spirometry were current smoking (OR 2.21; 95% CI 1.36-3.60), low educational level (OR 1.81; 1.09-3.02) and management in primary care (OR 2.28; 1.02-5.14). The correct interpretation of spirometry results increased (75% vs 82%; p = 0.010). Among patients with a repeated spirometry, 94% had a persistent FEV1/FVC or FEV1/VC ratio <0.70.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Diagnostic spirometry in patients with a new diagnosis of COPD.
Comparison of COPD cohorts PRAXIS I, patients diagnosed in the period 2000–2003 (below) and PRAXIS II, patients diagnosed in the period 2004–2010 (above).
Fig. 2
Fig. 2. Proportion of patients with spirometry result FEV1/FVC or FEV1/VC above/equal to or under 0.70.
Patients with assessable spirometry data and performed diagnostic spirometries from COPD cohorts PRAXIS I (n = 295) and PRAXIS II (n = 567).
Fig. 3
Fig. 3. Patient selection – PRAXIS II cohort.
Patients with a new diagnosis of COPD and performed/not performed diagnostic spirometry.
See this image and copyright information in PMC

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