Do physical signs reflect the degree of airflow obstruction in patients with asthma or chronic obstructive pulmonary disease?
The aim of the study was to relate the physical signs of the chest to the degree of airflow obstruction in asthma and COPD.


METHODS
113 patients with COPD and 76 patients with asthma were recruited from general practice. A standard physical examination of the chest was performed by trained medical students. Physical signs were related to the degree of airflow obstruction.


RESULTS
the signs correlating closely with the degree of airflow obstruction were: a prolonged expiratory phase, low-standing diaphragm, decreased expiratory breath sounds, noisy inspiratory sounds, and decreased diaphragmatic excursions. There was a fair correlation between the number of physical signs and the degree of airflow obstruction. This was especially the case in asthma (r = 0.62), but it was less clear in COPD (r = 0.45). Sensitivity of separate physical signs to detect airflow obstruction was less than 50%, but at least one of the signs was present in 70% of the patients with obstruction. Specificity of separate signs was more than 85%, apart from wheezing in asthma.


CONCLUSIONS
the combination of physical signs can offer relevant information in monitoring the severity of airflow obstruction in asthma and COPD.
van Schayck
C P
CP
Department of General Practice/Family Medicine, Nijmegen University, The Netherlands.
van Weel
C
C
Harbers
H J
HJ
van Herwaarden
C L
CL
D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity