New diagnostic criteria published in the Journal of COPD Foundation may increase the number of patients diagnosed with COPD by up to 15%.
According to a press release from National Jewish Health, the proposed diagnostic criteria better capture the full spectrum of those suffering from COPD and could result in better care for patients and stimulate research to slow or stop the progression of COPD.
COPD diagnosis. Source: Getty
“COPD continues to present an increasing burden on patients and the health care system. Although therapeutic options exist to improve pulmonary function and symptoms, there are limited options to stop or slow disease progression,” James D. Crapo, MD, National Jewish Health, Denver, Colorado and colleagues wrote in the review. “Although the pathological nature of the disease has been appreciated for centuries, current diagnostic criteria rely on spirometric measures. Over the past several years, it has become evident that patients without spirometric abnormalities experience respiratory symptoms and acute exacerbation-like events”
Crapo and colleagues evaluated a total of 8,784 smokers and former smokers who were enrolled in the COPDGene study.
While all smoking was shared criteria met by all patients included in the analysis, those who met two or three additional criteria had an increased risk of loss of lung function in five years or and had an increased risk of mortality.
Researchers documented patients’ environmental exposures, symptoms, structural abnormalities on CT scans, and lung function or spirometry. Measures were correlated with mortality and loss of lung function for five years and compared to patients who met no additional criteria.
According to the analysis, the designation of probable COPD was given to those who met two or three additional criteria. Patients with this designation had an 88% increased risk of losing significant lung function and an 89% increased risk of mortality.
Patients who met all diagnostic criteria were designated as having Definite COPD, according to the results. The chance of losing significant lung function over five years was almost double and the risk of mortality was five times as high among patients in this cohort.
"If we diagnose COPD based only on impaired lung function, then we miss many patients in the early stages of the disease. While some physicians do empirically treat patients with symptoms, many patients are not getting therapy that can improve their symptoms, their quality of life, and might extend their lives,” Crapo wrote in a press release. “Right now people who do not meet the current diagnostic criteria for COPD are not included in clinical trials of experimental COPD therapies. Our proposed diagnostic criteria could open clinical trials to these people, stimulate important research of potential therapies to slow, stop or even prevent progression of the disease."
Disclosure: The researchers report no relevant financial disclosures.