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Underdiagnosis and misclassification of COPD in Sweden: a Nordic Epilung study
Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.ORCID-id: 0000-0002-0553-8067
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.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.ORCID-id: 0000-0001-6622-3838
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2023 (Engelska)Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 217, artikel-id 107347Artikel i tidskrift (Refereegranskat) 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: The 1839 participants were selected from two ongoing large-scale epidemiological research programs: The Obstructive Lung Disease in Northern Sweden Studies and the West Sweden Asthma Study. COPDGOLD was defined according to the fixed post-bronchodilator spirometric criteria FEV1/FVC<0.70 in combination with respiratory symptoms.

Results: Among the 128 participants who fulfilled the criteria for COPDGOLD, 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.

Ort, förlag, år, upplaga, sidor
Elsevier, 2023. Vol. 217, artikel-id 107347
Nyckelord [en]
COPD, Epidemiology, Misclassification, Population study, Underdiagnosis
Nationell ämneskategori
Lungmedicin och allergi
Identifikatorer
URN: urn:nbn:se:umu:diva-212214DOI: 10.1016/j.rmed.2023.107347ISI: 001040057800001PubMedID: 37406781Scopus ID: 2-s2.0-85164438246OAI: oai:DiVA.org:umu-212214DiVA, id: diva2:1783463
Forskningsfinansiär
Hjärt-LungfondenVetenskapsrådetGöteborgs universitetVästra GötalandsregionenUmeå universitetRegion VästerbottenRegion NorrbottenAstma- och AllergiförbundetVisare NorrNordForskTillgänglig från: 2023-07-21 Skapad: 2023-07-21 Senast uppdaterad: 2025-04-24Bibliografiskt granskad

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Backman, HelenaStridsman, CarolineHedman, LinneaRönmark, EvaLindberg, Anne

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