Spirometry testing is a widely accepted and encouraged diagnostic method for chronic obstructive pulmonary disease (COPD), but new research shows that it is not used nearly enough. The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP) and reports that only one-third of patients with a COPD diagnosis ever received spirometry testing.
“Without proper testing, both underdiagnosis and misdiagnosis may occur, which can lead to improper therapies being prescribed,” said lead author MeiLan Han, MD, MS, University of Michigan, Division of Pulmonary and Critical Care Medicine. “This study shows that we have a lot of work ahead of us in terms of raising awareness among both patients and physicians.”
Along with colleagues from Johns Hopkins University, the University of Washington, and the National Committee for Quality Assurance, Dr. Han identified patients with newly diagnosed COPD by data collected from five health plans. The study examined patients aged 40 years and older, and determined if patients with a new diagnosis of COPD had received spirometry in the preceeding 720 days. Of the 5,039 eligible patients identified, only 32% were found to have received spirometry testing. Furthermore, only half of those patients received follow-up bronchodilator testing to confirm their diagnosis.
“In order to distinguish COPD from other diseases, such as asthma, spirometry must be measured both before and after administration of medication that dilates the airways,” Dr. Han explained. “As such, if COPD is suspected, initial spirometric testing should include bronchodilator testing too, in order for that patient to receive a truly diagnostic test.”
In addition, the study notes that these numbers contradict previous findings in which over 70% of physicians reported using spirometry for establishing a COPD diagnosis. Given the contrast, Dr. Han suggests a possible difference between what physicians say and what they actually do. Also of particular concern was that, according to this study, spirometry testing in those patients who were 75 years and older was performed less frequently, with only 28% of patients in this population receiving spirometry. Researchers point to the issue of ageism and question whether or not a patient’s age influences a physician’s decision to order diagnostic testing.
“The bad news is that we have significant room for improvement. The good news is that we have to know a problem exists before we can fix it, and now we know,” said Dr. Han. Other good news is that women and men fared virtually the same when it came to spirometry testing, despite previous reports suggesting women were tested less often.
“COPD is currently the fourth leading cause of death in the United States, and the economic burden of this disease is measured in the billions of dollars but, despite this, it is so often underdiagnosed or misclassified,” said Dr. Han. “Prior to this study, I did not truly appreciate the magnitude of spirometry underutilization, but my hope is that this study will lead to more correct diagnoses and better care of patients.”
“Spirometry testing is an inexpensive, quick, and painless procedure, which is necessary to confirm a COPD diagnosis,” said Mark J. Rosen, MD, FCCP, President of the American College of Chest Physicians. “In order to make a shift in the underutilization of spirometry, physicians need to use all of the resources available to them, and patients need to actively inquire about their care.”
The National Lung Health Education Program suggests that current and former smokers aged 45 years and older, as well as any patient who experiences cough, shortness of breath with exertion, or wheezing, ask their doctor about having a spirometry test performed.
Jennifer Stawarz | EurekAlert!
The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy