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Underdiagnosis and ...
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Axelsson, Malin,1964-Malmö universitet,Institutionen för vårdvetenskap (VV)
(author)
Underdiagnosis and misclassification of COPD in Sweden - A Nordic Epilung study
- Article/chapterEnglish2023
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LIBRIS-ID:oai:gup.ub.gu.se/329069
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https://gup.ub.gu.se/publication/329069URI
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https://doi.org/10.1016/j.rmed.2023.107347DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-212214URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-62019URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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.
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Backman, HelenaUmeå universitet,Avdelningen för hållbar hälsa,Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden(Swepub:umu)heaban01
(author)
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Nwaru, Bright I,1978Gothenburg 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(Swepub:gu)xnwabr
(author)
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Stridsman, CarolineUmeå universitet,Institutionen för folkhälsa och klinisk medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden(Swepub:umu)cast0052
(author)
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Vanfleteren, Lowie E G WGothenburg 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(Swepub:gu)xvanlo
(author)
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Hedman, Linnea,1979-Umeå universitet,Avdelningen för hållbar hälsa,Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden(Swepub:umu)evli0029
(author)
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Piirila, P.Unit of Clinical Physiology, HUS Medical Diagnostic Center, University Central Hospital, Finland and University of Helsinki, Helsinki, Finland
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Jalasto, J.Unit of Clinical Physiology, HUS Medical Diagnostic Center, University Central Hospital, Finland and University of Helsinki, Helsinki, Finland
(author)
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Langhammer, A.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
(author)
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Kankaanranta, Hannu,1967Gothenburg 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(Swepub:gu)xkankh
(author)
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Rådinger, Madeleine,1967Gothenburg 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(Swepub:gu)xradim
(author)
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Ekerljung, Linda,1979Gothenburg 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(Swepub:gu)xekeli
(author)
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Rönmark, EvaUmeå universitet,Avdelningen för hållbar hälsa,Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden(Swepub:umu)evra0004
(author)
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Lindberg, AnneUmeå universitet,Institutionen för folkhälsa och klinisk medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden(Swepub:umu)anelig02
(author)
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Malmö universitetInstitutionen för vårdvetenskap (VV)
(creator_code:org_t)
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In:Respiratory Medicine: Elsevier2170954-61111532-3064
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Piirila, P.
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