Home
|
Inbox
|
Search
|
View Abstract
Characterizing Undiagnosed Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A4984 - Characterizing Undiagnosed Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
Author Block: K. M. Johnson1, S. Bryan2, S. Ghanbarian1, D. Sin3, M. Sadatsafavi1; 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada, 2Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, Vancouver, BC, Canada, 3Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.
Rationale: A significant proportion of patients with chronic obstructive pulmonary disease (COPD) remain undiagnosed. Characterizing these patients can increase our understanding of the 'hidden' burden of COPD and the effectiveness of case detection interventions. Methods: We conducted a systematic review and meta-analysis to compare patient and disease factors between patients with undiagnosed persistent airflow limitation and those with diagnosed COPD. We searched MEDLINE and EMBASE for observational studies of adult patients meeting accepted spirometric definitions of COPD. We extracted and pooled summary data on the proportion or mean of each risk factor among diagnosed and undiagnosed patients (unadjusted analysis), and coefficients for the adjusted association between risk factors and diagnosis status (adjusted analysis). Results: 2,083 records were identified and 16 articles were used in the meta-analyses. Diagnosed patients were less likely to have mild (v. moderate to very severe) COPD (odds ratio [OR] 0.30, 95%CI 0.24-0.37, 6 studies) in unadjusted analysis. This association remained significant but its strength was attenuated in the adjusted analysis (OR 0.72, 95%CI 0.58-0.89, 2 studies). Diagnosed patients were more likely to report respiratory symptoms such as wheezing (OR 3.51, 95%CI 2.19-5.63, 3 studies) and phlegm (OR 2.16, 95%CI 1.38-3.38, 3 studies), had more severe dyspnea (mean difference in the modified Medical Research Council scale 0.52, 95%CI 0.40-0.64, 3 studies) and slightly greater smoking history than undiagnosed patients. Patient age, sex, current smoking status, and the presence of coughing were not associated with a previous diagnosis. Conclusions: Undiagnosed patients had less severe airflow obstruction and fewer respiratory symptoms than diagnosed patients. Lower disease burden in undiagnosed patients may significantly delay the diagnosis of COPD.
Author Block: K. M. Johnson1, S. Bryan2, S. Ghanbarian1, D. Sin3, M. Sadatsafavi1; 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada, 2Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, Vancouver, BC, Canada, 3Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.
Rationale: A significant proportion of patients with chronic obstructive pulmonary disease (COPD) remain undiagnosed. Characterizing these patients can increase our understanding of the 'hidden' burden of COPD and the effectiveness of case detection interventions. Methods: We conducted a systematic review and meta-analysis to compare patient and disease factors between patients with undiagnosed persistent airflow limitation and those with diagnosed COPD. We searched MEDLINE and EMBASE for observational studies of adult patients meeting accepted spirometric definitions of COPD. We extracted and pooled summary data on the proportion or mean of each risk factor among diagnosed and undiagnosed patients (unadjusted analysis), and coefficients for the adjusted association between risk factors and diagnosis status (adjusted analysis). Results: 2,083 records were identified and 16 articles were used in the meta-analyses. Diagnosed patients were less likely to have mild (v. moderate to very severe) COPD (odds ratio [OR] 0.30, 95%CI 0.24-0.37, 6 studies) in unadjusted analysis. This association remained significant but its strength was attenuated in the adjusted analysis (OR 0.72, 95%CI 0.58-0.89, 2 studies). Diagnosed patients were more likely to report respiratory symptoms such as wheezing (OR 3.51, 95%CI 2.19-5.63, 3 studies) and phlegm (OR 2.16, 95%CI 1.38-3.38, 3 studies), had more severe dyspnea (mean difference in the modified Medical Research Council scale 0.52, 95%CI 0.40-0.64, 3 studies) and slightly greater smoking history than undiagnosed patients. Patient age, sex, current smoking status, and the presence of coughing were not associated with a previous diagnosis. Conclusions: Undiagnosed patients had less severe airflow obstruction and fewer respiratory symptoms than diagnosed patients. Lower disease burden in undiagnosed patients may significantly delay the diagnosis of COPD.
|
Home
|
Inbox
|
Search
|