The diagnostic accuracies of chronic obstructive pulmonary disease (COPD) in general practice: The results of the MAGIC (Manchester Airways Group Identifying COPD) study.
BACKGROUND
Although it is generally accepted that chronic obstructive pulmonary disease (COPD) is underdiagnosed, there is little objective information concerning the size of the problem in the UK.


METHODS
Patients from two general practices were offered spirometry if they were aged 30 or older, had reported ever smoking in one of four postal respiratory surveys (1993-2001), and/or reported four or more symptoms or risk factors in 2001 indicating likely obstructive airways disease.


RESULTS
Of 2646 subjects invited, 871 attended and 825 had adequate spirometry results for analysis. In all, 163 patients had spirometrically-confirmed COPD; 103 of these (63.2%) had no recorded COPD in their practice records, including 14 out of 31 (45.2%) whose spirometry results classified them as having severe or very severe COPD.


CONCLUSIONS
This study found a considerable under-recording of COPD in two general practices. This may be due to a combination of administrative and diagnostic problems (including the under-use of spirometers), and a reluctance of patients to present with their symptoms. These results have important implications in terms of unmet need and resource utilisation.
Frank
Timothy L
TL
General Practice Research Unit, North West Lung Research Centre, Wythenshawe Hospital, Manchester, M23 9LT, UK. gpresearchunit@yahoo.co.uk
Hazell
Michelle L
ML
Linehan
Mary F
MF
Frank
Peter I
PI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D013147:Spirometry; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology