The validity of the diagnosis of chronic obstructive pulmonary disease in general practice.
OBJECTIVE
To determine the validity of the diagnosis of chronic obstructive pulmonary disease (COPD) in general practice in patients given a diagnosis of COPD and treated with bronchodilators.


METHODS
From the medical records of eight Health Centres in Northern Greece, 319 subjects aged over 40 years and diagnosed as "COPD" were entered into the study. All filled in a special questionnaire and were subjected to spirometry, rhinomanometry and chest X-ray.


RESULTS
One hundred and sixty patients (50.2%) met the GOLD criteria for COPD. Twenty-six of them were non-smokers and underwent further evaluation: blood eosinophil count, serum IgE assay, high resolution computed tomography (HRCT) scan of the chest, and echocardiography; 16 were given a different diagnosis. One hundred and fifty-nine subjects (49.8%) with an FEV1/ FVC ratio >0.7 did not meet the GOLD criteria for COPD; 71 suffered from nasal obstruction, 13 from asthma, six had restrictive pulmonary disease and 69 had no respiratory disease.


CONCLUSIONS
Diagnostic errors in patients with respiratory symptoms in the primary healthcare setting are frequent. Patients suspected to have COPD should undergo spirometry testing after bronchodilation. An alternative diagnosis must be sought for non-smoking patients with irreversible airway obstruction.
Sichletidis
Lazaros
L
Aristotle University of Thessalonica, Laboratory for the Investigation of Environmental Diseases, G. Papanicolaou General Hospital, Thessalonica, Greece. sichlet@med.auth.gr
Chloros
Diamantis
D
Spyratos
Dionisios
D
Chatzidimitriou
Nicolaos
N
Chatziiliadis
Petros
P
Protopappas
Nicolaos
N
Charalambidou
Olympia
O
Pelagidou
Despina
D
Zarvalis
Elias
E
Patakas
Dimitros
D
D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005194:Family Practice; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy*; D011859:Radiography; D015203:Reproducibility of Results; D025363:Rhinomanometry; D013147:Spirometry; D011795:Surveys and Questionnaires