Nav: Home

New research hopes to identify individuals at risk of clinically significant COPD

June 25, 2019

New research from the University of Alabama at Birmingham provides evidence, for the first time, for physicians to continue using the spirometry criteria set by major respiratory societies for the diagnosis of airflow obstruction and chronic obstructive pulmonary disease.

Published in the Journal of the American Medical Association, Surya Bhatt, M.D., associate professor in the Division of Pulmonary, Allergy and Critical Care Medicine and medical director of the UAB Pulmonary Function and Exercise Physiology Lab, says there is much confusion and debate in the medical community on what are the best spirometry criteria to use for diagnosing COPD.

Currently, major respiratory society guidelines recommend diagnosing airflow obstruction when the ratio of the forced expiratory volume in one second (FEV1) to the forced vital capacity (FVC) is less than a fixed threshold of 0.70. This means that, during a forced exhalation following a maximal inhalation, a normal individual should be able to blow out at least 70 percent of their lung size or vital capacity in the first second. However, there is no rigorous, population-based evidence to support the threshold of 0.70, which was set by expert opinion as the optimal FEV1/FVC threshold for defining clinically significant airflow obstruction, according to the published research.

"A diagnosis of COPD needs confirmation by demonstrating obstruction to airflow using spirometry," Bhatt said. "The currently used criteria are based on expert opinion, and until these results were published, there was not enough evidence to support their use."

The multisite team, led by researchers from UAB and the University of Columbia, analyzed data from a large, multi-ethnic sample of 24,207 adults in the United States, and found that the currently used threshold of 0.70 provided discrimination of COPD-related hospitalization and mortality that was not significantly different from -- or was more accurate than -- other fixed thresholds. The 0.70 threshold was also more accurate than other thresholds that define normal lung function and are derived from reference populations. These results support the continued use of FEV1/FVC <0.70 to identify individuals at risk of clinically significant COPD.

Cigarette smoking is the primary cause of COPD in the United States, but air pollutants at home (secondhand smoke and some heating fuels), at work (dusts, gases and fumes) and for those with genetic predisposition also can cause COPD. COPD makes breathing difficult for the estimated 14 million Americans who have this disease. Millions more suffer from COPD, but have not been diagnosed. Although there is no cure, it can be treated.

"The ongoing disagreement between experts on the best spirometry criteria to diagnose airflow obstruction has resulted in a lack of clarity for clinicians," Bhatt said. "Using a simple standard threshold has the potential to improve the diagnosis and treatment of this common disease."

According to the Centers for Disease Control and Prevention, Alabama has one of the highest rates of COPD. About 9.6 percent of Alabama residents surveyed in 2011 reported having been told by a health care professional that they have COPD. "The symptoms of COPD are often non-specific, and an accurate diagnosis will determine who gets appropriately treated, and is also important for avoiding unnecessary therapies," Bhatt said.
-end-


University of Alabama at Birmingham

Related Copd Articles:

Treatment seeks to address exacerbations of COPD
A new study finds that delivery of oxygen via high-flow nasal tubes may help patients who experience exacerbations of chronic obstructive pulmonary disease (COPD).
Study reveals surprises concerning COPD and smoking
A new study challenges the widely accepted but oversimplified description of airway inflammation in smokers and patients with chronic obstructive pulmonary disease (COPD).
New guidelines for treatment and management of COPD exacerbations
A multi-disciplinary ERS/ATS task force of chronic obstructive pulmonary disease (COPD) experts has published comprehensive new guidelines on the treatment of COPD exacerbations.
New genetic markers for COPD discovered
In a new Research Letter published in Nature Genetics on Feb.
COPD -- what causes the lungs to lose their ability to heal?
In chronic obstructive pulmonary disease (COPD), the patients' lungs lose their ability to repair damages on their own.
New technology detects COPD in minutes
Pioneering research by Professor Paul Lewis of Swansea University's Medical School into one of the most common lung diseases in the UK, Chronic Obstructive Pulmonary Disease, has led to the development of a new technology that can quickly and easily diagnose and monitor the condition.
COPD exacerbations lead to lung function decline, particularly among those with mild COPD
Acute exacerbations of chronic obstructive pulmonary disease, or COPD, are associated with significant long-term lung function loss, according to research published online, ahead of print in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
Depression decreases adherence to COPD maintenance medications
A recent study in the Annals of the American Thoracic Society found that in a nationally representative sample of Medicare beneficiaries who were newly diagnosed with COPD, adherence to maintenance medications decreased with new episodes of depression.
Care for COPD: Could more be done?
Meilan Han, M.D., an associate professor of internal medicine at the University of Michigan and the medical director of the U-M Women's Respiratory Health Program, is the lead author on a new report that set out to provide a comprehensive view of COPD care in the US.
COPD symptoms common among smokers, even when undiagnosed
A new study in the New England Journal of Medicine finds that smokers, who wouldn't typically be diagnosed with chronic obstructive pulmonary disease, or COPD, are still showing symptoms consistent with the diagnosis.

Related Copd Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#532 A Class Conversation
This week we take a look at the sociology of class. What factors create and impact class? How do we try and study it? How does class play out differently in different countries like the US and the UK? How does it impact the political system? We talk with Daniel Laurison, Assistant Professor of Sociology at Swarthmore College and coauthor of the book "The Class Ceiling: Why it Pays to be Privileged", about class and its impacts on people and our systems.