Article Text

Download PDFPDF
Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty: a BOLD analysis—authors’ reply
  1. Peter Burney1,
  2. Bernet Kato1,
  3. Christer Janson2,
  4. David Mannino3,
  5. Michael Studnicka4,
  6. Wan Tan5,
  7. Eric Bateman6,
  8. Ali Koçabas7,
  9. William M Vollmer8,
  10. Thorarrin Gislason9,
  11. Guy Marks10,
  12. Parvaiz A Koul11,
  13. Louisa Gnatiuc1,
  14. Sonia Buist12
  15. for the Burden of Obstructive Lung Disease (BOLD) Study
  1. 1 National Heart & Lung Institute, Imperial College, London, UK
  2. 2 Department of Medical Sciences: Respiratory Medicine & Allergology, Uppsala University, Uppsala, Sweden
  3. 3 Division of Pulmonary Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky, USA
  4. 4 Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
  5. 5 James Hogg Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
  6. 6 Division of Pulmonology, University of Cape Town Lung Institute, Cape Town, South Africa
  7. 7 Department of Chest Diseases, Cukurova University School of Medicine, Adana, Turkey
  8. 8 Kaiser Permanente Center for Health Research, Portland, Oregon, USA
  9. 9 Landspitali University Hospital, Reykjavik, Iceland
  10. 10 Woolcock Institute of Medical Research, Sydney, Australia
  11. 11 Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
  12. 12 Oregon Health & Sciences University, Portland, Oregon, USA
  1. Correspondence to Professor Peter Burney, National Heart and Lung Institute, Emmanuel Kaye Building, Imperial College, 1 Manresa Road, London SW3 6RL, UK; p.burney{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We are grateful to Dr Stanojevic and her colleagues1 for their interest in our paper.2

On their first point we assume that they mean mortality rates not national prevalence rates. In either case the weak association between diagnosis and spirometric findings is already well known and unsurprising given that very few people have spirometric testing. In the case of death certificates the situation is further confounded by the limited choice of International Classification of Disease codes for people dying with chronic lung disease.

Their second paragraph deals with two separate issues, the potential divergence between national and local statistics and the interpretation of ecological analyses. They are right to repeat our caveat that national data do not necessarily reflect local conditions. For gross …

View Full Text


  • Contributors PB drafted the response and finalised it. The other authors commented on the first draft and agreed the final document.

  • Competing interests PB reports grants from Wellcome Trust and the UK Department of Health, during the conduct of the study; other from Glaxo Smith Kline, outside the submitted work; WMV reports grants from Merck, grants from Boehringer Ingelheim, Pfizer, Altana GlaxoSmithKline, AstraZeneca, Novartis, and Chiesi, during the conduct of the study; DM has received honoraria/consulting fees and research funding from GlaxoSmithKline plc, Novartis Pharmaceuticals, Pfizer Inc., Boehringer-Ingelheim, AstraZeneca PLC, Forest Laboratories Inc., Merck, and Creative Educational Concepts. Furthermore, he has received royalties from Up-to-Date. WT reports grants from Joint sponsorship by GSK, AZ, BI, Altana, Norvatis, Pfizer, outside the submitted work; MS reports grants from Altana, Astra-Zeneca, Boehringer-Ingelheim, Glaxo-Smith-Kline, Merck Sharpe & Dome, Novartis, Salzburger Gebietskrankenkasse, and Salzburg Local Government during the conduct of the study; grants and personal fees from Boehringer-Ingelheim, Altana-Nycomed, Chiesi and Astra-Zeneca, grants and non-financial support from Air-Liquide, and personal fees from Menarini, and Glaxo-Smith-Kline outside the submitted work; GM reports grants from GlaxoSmithKline, AstraZeneca, Boehringer Ingelheim, Air Liquide, Australian Lung Foundation, National Health and Medical Research Council during the conduct of the study; other from Novartis, outside the submitted work.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Linked Articles