title: Incidence of chronic obstructive pulmonary disease based on three spirometric diagnostic criteria in Sao Paulo, Brazil: a nine-year follow-up since the PLATINO prevalence study.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is a respiratory disease of high prevalence and socioeconomic impact worldwide. It affects approximately 16% of the population of São Paulo. The incidence of COPD is still unknown in Brazil. The aim of this study was to estimate new cases of COPD in a population-based sample in São Paulo, Brazil, using three different spirometric diagnostic criteria, and to assess the concordance between these criteria.
  
  
  METHODS
  Prospective cohort study, in the city of São Paulo, Brazil.
  
  
  METHODS
  A questionnaire was applied and anthropometry and pre and post-bronchodilator spirometry were performed on the same subjects as in the initial PLATINO study (2003) in São Paulo. Data from this follow-up study were added to the original database of the initial phase. Incident COPD cases refer to subjects who developed the disease in accordance with each spirometric criterion during the nine-year follow-up period. The Statistical Package for the Social Sciences, version 17.0 (SPSS Inc., Chicago, IL, USA) was used in the analysis and the significance level was set at P < 0.05.
  
  
  RESULTS
  613 subjects participated in the follow-up. New COPD cases ranged in frequency from 1.4% to 4.0%, depending on the diagnostic criterion used. The concordance between the criteria ranged from 35% to 60%.
  
  
  CONCLUSIONS
  The incidence of COPD after a nine-year follow-up was high, but varied according to the spirometric criterion used. The agreement between the criteria for identifying new cases of the disease ranged from 35% to 60%.
authors.affiliation: Department of Translational Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Graciane Laender
authors.initials: GL
authors.lastname: Moreira
authors.affiliation: Department of Physiotherapy, Centro Universitário São Camilo, São Paulo, Brazil.
authors.forename: Mariana Rodrigues
authors.initials: MR
authors.lastname: Gazzotti
authors.affiliation: Department of Translational Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Beatriz Martins
authors.initials: BM
authors.lastname: Manzano
authors.affiliation: Pulmonology Sector, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Oliver
authors.initials: O
authors.lastname: Nascimento
authors.affiliation: National Institute of Respiratory Diseases, Mexico City, Mexico.
authors.forename: Rogelio
authors.initials: R
authors.lastname: Perez-Padilla
authors.affiliation: Department of Internal Medicine, School of Medicine, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
authors.forename: Ana Maria Baptista
authors.initials: AM
authors.lastname: Menezes
authors.affiliation: Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Jardim
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000886:Anthropometry; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012959:Socioeconomic Factors; D013147:Spirometry / Q000379:methods