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Underdiagnosis and misclassification of COPD in Sweden - A Nordic Epilung study

Axelsson, Malin, 1964- (author)
Malmö universitet,Institutionen för vårdvetenskap (VV)
Backman, Helena (author)
Umeå universitet,Avdelningen för hållbar hälsa,Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden
Nwaru, Bright I, 1978 (author)
Gothenburg University,Göteborgs universitet,Wallenberg Centre for Molecular and Translational Medicine,Krefting Research Centre,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Stridsman, Caroline (author)
Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
Vanfleteren, Lowie E G W (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
Hedman, Linnea, 1979- (author)
Umeå universitet,Avdelningen för hållbar hälsa,Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden
Piirila, P. (author)
Unit of Clinical Physiology, HUS Medical Diagnostic Center, University Central Hospital, Finland and University of Helsinki, Helsinki, Finland
Jalasto, J. (author)
Unit of Clinical Physiology, HUS Medical Diagnostic Center, University Central Hospital, Finland and University of Helsinki, Helsinki, Finland
Langhammer, A. (author)
HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
Kankaanranta, Hannu, 1967 (author)
Gothenburg University,Göteborgs universitet,Krefting Research Centre,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Seinäjoki, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
Rådinger, Madeleine, 1967 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Krefting Research Centre,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Ekerljung, Linda, 1979 (author)
Gothenburg University,Göteborgs universitet,Krefting Research Centre,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Rönmark, Eva (author)
Umeå universitet,Avdelningen för hållbar hälsa,Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden
Lindberg, Anne (author)
Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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 (creator_code:org_t)
Elsevier, 2023
2023
English.
In: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 217
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Introduction: The prevalence of COPD tends to level off in populations with decreasing prevalence of smoking but the extent of underdiagnosis in such populations needs further investigation.Aim: To investigate underdiagnosis and misclassification of COPD with a focus on socio-economy, lifestyle determinants and healthcare utilization.Method: The 1839 participants were selected from two ongoing large-scale epidemiological research programs: The Obstructive Lung Disease in Northern Sweden Studies and the West Sweden Asthma Study. COPDGOLD was defined according to the fixed post-bronchodilator spirometric criteria FEV1/FVC<0.70 in combination with respiratory symptoms. Results: Among the 128 participants who fulfilled the criteria for COPDGOLD, the underdiagnosis was 83.6% (n = 107) of which 57.9% were men. The undiagnosed participants were younger, had higher FEV1% of predicted and less frequently a family history of bronchitis. One in four of the undiagnosed had utilized healthcare and had more frequently utilized healthcare due to a burden of respiratory symptoms than the general population without COPD. Underdiagnosis was not related to educational level. Misclassification of COPD was characterized by being a woman with low education, ever smoker, having respiratory symptoms and having a previous asthma diagnosis.Conclusion: In the high income country Sweden, the underdiagnosis of COPD was highly prevalent. Reduced underdiagnosis can contribute to risk factor modification, medical treatment and self-management strategies in early stages of the disease, which may prevent disease progression and improve the quality of life among those affected. Therefore, there is a need to increase the use of spirometry in primary care to improve the diagnostic accuracy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

Keyword

COPD
Population study
Epidemiology
Underdiagnosis
Misclassification
COPD

Publication and Content Type

ref (subject category)
art (subject category)

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