title: [The adequacy of the diagnostic in chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  To assess the adequacy to the clinical guides (GOLD/SEPAR) for the diagnosis of the patients classified as COPD.
  
  
  METHODS
  We selected all COPD cases in the registry of chronic patients of 28 general practitioners from 9 Health Centres in the province of Ourense (Spain). A total of 382 cases were included. Diagnostic accuracy was determined according to the results of spirometry. We identify factors associated with correct diagnosis by logistic regression which included age, gender, residence (rural/urban), smoking, severity, level of follow up and time since diagnosis.
  
  
  RESULTS
  Of the total number included, 297 were male (77.7%) and 172 patients (45.0%) came from rural areas. The average age was 77.0 (SD=±11.0) years, with a mean age at diagnosis of 64.9 (±12.0) years and the time from diagnosis was 11.5 (±8.0) years. Less than half (49.1%) patients had been smokers, and 13.1% still smoked. Twenty-six cases (6.8%) were diagnosed in Primary Care. The FEV(1)/FVC ratio was recorded in 174 (45.5%) patients, with less than 0.7 in 138 cases (36.1%), which were considered as correctly diagnosed. In these patients the FEV(1) had been recorded in 125 cases (90.6%). A correct diagnosis was associated with severe or very severe disease (OR 5.2; 95% CI; 1.5-17.4), urban areas (OR 6.1; 95% CI, 1.7-21.2), and younger than 60 years (OR 3.7; 95% CI, 1.3-11.2).
  
  
  CONCLUSIONS
  The number of spirometry results recorded in the Primary Care medical records of patients diagnosed with COPD was found to be low, and with little adaptation to the accepted diagnostic criteria in the guidelines that are used routinely.
authors.affiliation: SERGAS. C. S. Cea, Cea, Ourense, España. gabriel.diaz.gravalos@sergas.es
authors.forename: G J
authors.initials: GJ
authors.lastname: Díaz-Grávalos
authors.forename: G
authors.initials: G
authors.lastname: Palmeiro-Fernández
authors.forename: M D
authors.initials: MD
authors.lastname: Valiño-López
authors.forename: A
authors.initials: A
authors.lastname: Robles-Castiñeiras
authors.forename: M J
authors.initials: MJ
authors.lastname: Fernández-Silva
authors.forename: S
authors.initials: S
authors.lastname: Reinoso-Hermida
authors.forename: I
authors.initials: I
authors.lastname: Casado-Górriz
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D012129:Respiratory Function Tests