Editorial: Diagnosing COPD ||FREE PAPER||

David MG Halpin

Consultant Physician, Royal Devon & Exeter Hospital, barrack Road, Exeter EX2 5DW, UK

It is widely recognized that many people with chronic obstructive pulmonary disease (COPD) are undiagnosed, including some with significant airflow obstruction. The best available data suggest that the prevalence of physiologically defined COPD in adults aged 40 years is 9%–10% (Halbert et al 2006). In their study of randomly selected individuals aged 60 to 74 years from a UK general practice register, Dickinson and colleagues (1999) found that there were 2.69 “true” cases of COPD for each diagnosed case, with an overall prevalence of 6.2% with undiagnosed COPD. A similar study of a random sample of the general population aged over 64 years in Finland found 1.99 and 1.62 true cases of COPD for each diagnosed case in men and women, respectively (Isoha et al 1994). Other studies have compared the prevalence of respiratory symptoms with patient-reported diagnoses and found a ratio of true COPD cases to self-reported diagnoses ranging from approximately 1.5 to 4 (Littlejohns et al 1989; Lundback et al 1991; Viegi et al 1991; Lai et al 1995). Most recently a study in Manchester by Frank and colleagues (2006) found that nearly two thirds of patients with spirometrically confirmed COPD had no prior diagnosis of COPD and nearly half of these had severe airflow obstruction.