Issues in Pulmonary Function Testing and COPD
Purpose of Review The purpose of this review article is to provide an up-to-date summary on the current evidence for or against the use of lung function tests as screening and diagnostic tools for airflow obstruction in chronic obstructive pulmonary disease (COPD), and to consider the relevant issues in context
Recent Findings COPD is characterized by chronic respiratory symptoms and airflow limitation with only partial reversibility on lung function testing. However, screening on a population basis or of an enriched 'at-risk' subset like chronic smokers is not supported by findings from previous epidemiological studies, screening trials or in currently published clinical management guidelines by professional societies and review bodies. The definition of airflow obstruction and the classification of disease severity of COPD also differ slightly between guidelines and statements from different professional societies.
Summary Given the experience from previous screening trials and controversial classification of airflow obstruction by severity, it is impossible to have accurate screening results for COPD based on lung function tests alone. Clinical respiratory symptoms should be taken into consideration in terms of the diagnosis and management of COPD, as well as in any screening trial or programme that is to be attempted or implemented.
Lung function testing is an established tool for the diagnosis of airflow obstruction. It is the recommended test for classification of disease severity in chronic obstructive pulmonary disease (COPD). Various respiratory societies and international consortiums have established formal guidelines on lung function testing which cover areas ranging from the metrics of test performance to the interpretation of lung function tests in disease recognition.
Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide, and is projected to rank fifth in all-cause global mortality by the year 2020. This is attributed to a combination of persistently high smoking prevalence in many developing countries and the trend of aging populations in the developed world. Although COPD represents a major burden to public health, data from epidemiological studies available to date do not support population screening for COPD, even among the 'at-risk' populations, either with the use of questionnaires or spirometry or combination of these tools.
The purpose of this article is to review the current body of published evidence that has contributed to our knowledge regarding the use of lung function tests as screening and diagnostic tools for COPD – with particular focus on those articles published in the recent 1–2 years.
Abstract and Introduction
Abstract
Purpose of Review The purpose of this review article is to provide an up-to-date summary on the current evidence for or against the use of lung function tests as screening and diagnostic tools for airflow obstruction in chronic obstructive pulmonary disease (COPD), and to consider the relevant issues in context
Recent Findings COPD is characterized by chronic respiratory symptoms and airflow limitation with only partial reversibility on lung function testing. However, screening on a population basis or of an enriched 'at-risk' subset like chronic smokers is not supported by findings from previous epidemiological studies, screening trials or in currently published clinical management guidelines by professional societies and review bodies. The definition of airflow obstruction and the classification of disease severity of COPD also differ slightly between guidelines and statements from different professional societies.
Summary Given the experience from previous screening trials and controversial classification of airflow obstruction by severity, it is impossible to have accurate screening results for COPD based on lung function tests alone. Clinical respiratory symptoms should be taken into consideration in terms of the diagnosis and management of COPD, as well as in any screening trial or programme that is to be attempted or implemented.
Introduction
Lung function testing is an established tool for the diagnosis of airflow obstruction. It is the recommended test for classification of disease severity in chronic obstructive pulmonary disease (COPD). Various respiratory societies and international consortiums have established formal guidelines on lung function testing which cover areas ranging from the metrics of test performance to the interpretation of lung function tests in disease recognition.
Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide, and is projected to rank fifth in all-cause global mortality by the year 2020. This is attributed to a combination of persistently high smoking prevalence in many developing countries and the trend of aging populations in the developed world. Although COPD represents a major burden to public health, data from epidemiological studies available to date do not support population screening for COPD, even among the 'at-risk' populations, either with the use of questionnaires or spirometry or combination of these tools.
The purpose of this article is to review the current body of published evidence that has contributed to our knowledge regarding the use of lung function tests as screening and diagnostic tools for COPD – with particular focus on those articles published in the recent 1–2 years.
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