European Respiratory Journal · 2002 · 490 citations · 12 references
MedicineClinical SciencesInternal MedicineClinical EpidemiologyPulmonary Function TestingPulmonologyChronic Obstructive Pulmonary DiseaseDyspnea AssessmentForced Vital CapacityObstructive Lung DiseasePulmonary Function AssessmentRespiratory DiseaseAsymptomatic PrevalenceChronic Obstructive Pulmonary Disease AssessmentChronic Obstructive Pulmonary Disease SpirometryForced Expiratory Volume AssessmentForced Vital Capacity RatioPatient-reported Dyspnea AssessmentSpirometrySpirometry Interpretation Criteria
The GOLD criteria define stage 1 COPD as FEV1/FVC < 70 % with FEV1 %pred > 80 % and stage 2 as FEV1/FVC < 70 % with FEV1 %pred < 80 %. The study assessed how the GOLD criteria misclassify healthy, never‑smoking adults over 70 and argued that COPD staging should be age‑specific. Researchers mailed a respiratory questionnaire to 2,871 adults over 70, then performed spirometry on 71 never‑smokers without respiratory disease in a randomly selected subgroup of 208 respondents. About 35 % of healthy, elderly never‑smokers met the GOLD definition of stage 1 COPD, rising to ~50 % in those over 80, indicating that the criteria will likely over‑diagnose COPD in this population.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has defined stage 1 chronic obstructive pulmonary disease (COPD) as forced expiratory volume in one second/forced vital capacity (FEV 1 /FVC)% <70% and a FEV 1 % predicted of >80%. Stage 2 has been defined as FEV 1 /FVC <70% and a FEV 1 % pred of <80%. The authors examined the extent of COPD misdiagnosis using this definition in healthy, never-smoker, asymptomatic adults aged >70 yrs in Bergen, Norway. A respiratory questionnaire was mailed to a random sample of 2,871 persons aged>70 yrs. In a random, well-defined subgroup of 208 never-smoker respondents with no current respiratory disease and significant dyspnoea or heart disease/hypertension complicated with dyspnoea, 71 were able to perform an acceptable spirometry. Approximately 35% of these healthy, elderly never-smokers had an FEV 1 /FVC% of <70% and would be classified as having at least a stage 1 COPD. This percentage increased with age and in those aged >80 yrs ∼50% would be classified as having COPD and approximately one-third would have an FEV 1 of <80% pred (stage 2 COPD). The estimated 5th percentile of FEV 1 was consistently <80% pred. The Global Initiative for Chronic Obstructive Lung Disease criteria will probably lead to a significant degree of over-diagnosis of chronic obstructive pulmonary disease in those aged >70 yrs. The criteria used to define the various stages of chronic obstructive pulmonary disease need to be age-specific.
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Lung volumes and forced ventilatory flows
PH Quanjer, G J Tammeling, J. E. Cotes et al. · European Respiratory Journal · 1993 · 5.3K citations · Full text
Quanjer Ph, Tammeling Gj, Cotes Je et al. · PubMed · 1993 · 3.8K citations
Health Professions, Clinical Sciences, Internal Medicine +17
The cardiovascular health study: Design and rationale
Linda P. Fried, Nemat O. Borhani, Paul Enright et al. · Annals of Epidemiology · 1991 · 3.7K citations