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Underdiagnosis and misclassification of COPD in Sweden - A Nordic Epilung study
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0001-5493-8334
Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN unit, Umeå University, Umeå, Sweden.
Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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2023 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 217, article id 107347Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The prevalence of COPD tends to level off in populations with decreasing prevalence of smoking but the extent of underdiagnosis in such populations needs further investigation.

AIM: To investigate underdiagnosis and misclassification of COPD with a focus on socio-economy, lifestyle determinants and healthcare utilization.

METHOD: was defined according to the fixed post-bronchodilator spirometric criteria FEV1/FVC<0.70 in combination with respiratory symptoms.

RESULTS: , the underdiagnosis was 83.6% (n = 107) of which 57.9% were men. The undiagnosed participants were younger, had higher FEV1% of predicted and less frequently a family history of bronchitis. One in four of the undiagnosed had utilized healthcare and had more frequently utilized healthcare due to a burden of respiratory symptoms than the general population without COPD. Underdiagnosis was not related to educational level. Misclassification of COPD was characterized by being a woman with low education, ever smoker, having respiratory symptoms and having a previous asthma diagnosis.

CONCLUSION: In the high income country Sweden, the underdiagnosis of COPD was highly prevalent. Reduced underdiagnosis can contribute to risk factor modification, medical treatment and self-management strategies in early stages of the disease, which may prevent disease progression and improve the quality of life among those affected. Therefore, there is a need to increase the use of spirometry in primary care to improve the diagnostic accuracy.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 217, article id 107347
Keywords [en]
COPD, Epidemiology, Misclassification, Population study, Underdiagnosis
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:mau:diva-62019DOI: 10.1016/j.rmed.2023.107347ISI: 001040057800001PubMedID: 37406781Scopus ID: 2-s2.0-85164438246OAI: oai:DiVA.org:mau-62019DiVA, id: diva2:1789747
Available from: 2023-08-21 Created: 2023-08-21 Last updated: 2023-10-11Bibliographically approved

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