Chest
Volume 129, Issue 4, April 2006, Pages 833-835
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Editorials
Does Screening for COPD by Primary Care Physicians Have the Potential to Cause More Harm Than Good?

https://doi.org/10.1378/chest.129.4.833Get rights and content

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    For women around 30 years old, it is abnormal already when FEV1/FVC ratio is 0.75; while for people older than 70 years old whose FEV1/FVC ratio is less than 0.7, over 30% of them are healthy (Postma et al., 2015). Many over-diagnosis cases that patients with a diagnosis of COPD have normal lung cancer were reported (Enright, 2006; Wilt et al., 2005). Thus, more accurate and convenient COPD diagnosis method is in urgent need.

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    We observed that non-diagnosed participants with AO were more likely to have symptoms (symptoms of chronic bronchitis, wheezing, and exertional dyspnoea) than participants without AO. The putative use of more aggressive screening COPD strategies has been criticized by some researchers, who argue that (i) few interventions are efficient in early-stage disease and (ii) the costs associated with false positives would be prohibitive [53]. However, Csikesz and Gartman recently reviewed possible options for early COPD screening and associated care [54].

  • Validation of a COPD screening questionnaire and establishment of diagnostic cut-points in a Japanese general population: The Hisayama study

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    The reason for this discrepancy is not clear, but backgrounds of the study subjects may affect cut-points. In addition to the difference between Asian and Western populations, the present study is population-based while patients from general practice and specialist sites were involved in the previous report.9 In this study, a cut-point of 5 resulted in a lower sensitivity of 34.9% and a smaller area under the ROC curve of 0.57 compared with a cut-point of 4.

  • Diagnostic score for COPD: Validation of the DS-COPD in clinical settings

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    Spirometry is required for final diagnosis,5,6 but is not always feasible in non-tertiary care hospitals; even if available, it still requires expertise for results interpretation.7 Not to mention that portable spirometry devices may be expensive, require high technical skills and patients' learning efforts.7,8 Moreover, using systematic testing for early detection without pre-selection of at-risk patients result in wasting healthcare resources.7

  • Spirometry

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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Dr. Enright is Research Professor of Medicine and Public Health, University of Arizona Mel and Enid Zuckerman College of Public Health.

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