COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.

Acknowledgement of COPD underdiagnosis and misdiagnosis in primary care can contribute to improved disease diagnosis. PUMA is an international primary care study in Argentina, Colombia, Venezuela and Uruguay.To assess COPD underdiagnosis and misdiagnosis in primary care and identify factors associat...

Full description

Bibliographic Details
Main Authors:	Alejandro Casas Herrera, Maria Montes de Oca, Maria Victorina López Varela, Carlos Aguirre, Eduardo Schiavi, José R Jardim, PUMA Team
Format:	Article
Language:	English
Published:	Public Library of Science (PLoS) 2016-01-01
Series:	PLoS ONE
Online Access:	http://europepmc.org/articles/PMC4830516?pdf=render

id	doaj-e1d6dd6c1e1842d5bcf9e3ca1345baae
record_format	Article
spelling	doaj-e1d6dd6c1e1842d5bcf9e3ca1345baae2020-11-25T00:08:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01114e015226610.1371/journal.pone.0152266COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.Alejandro Casas HerreraMaria Montes de OcaMaria Victorina López VarelaCarlos AguirreEduardo SchiaviJosé R JardimPUMA TeamAcknowledgement of COPD underdiagnosis and misdiagnosis in primary care can contribute to improved disease diagnosis. PUMA is an international primary care study in Argentina, Colombia, Venezuela and Uruguay.To assess COPD underdiagnosis and misdiagnosis in primary care and identify factors associated with COPD underdiagnosis in this setting.COPD was defined as post-bronchodilator (post-BD) forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) <0.70 and the lower limit of normal (LLN). Prior diagnosis was self-reported physician diagnosis of emphysema, chronic bronchitis, or COPD. Those patients with spirometric COPD were considered to have correct prior diagnosis, while those without spirometric criteria had misdiagnosis. Individuals with spirometric criteria without previous diagnosis were considered as underdiagnosed.1,743 patients were interviewed, 1,540 completed spirometry, 309 (post-BD FEV1/FVC <0.70) and 226 (LLN) had COPD. Underdiagnosis using post-BD FEV1/FVC <0.70 was 77% and 73% by LLN. Overall, 102 patients had a prior COPD diagnosis, 71/102 patients (69.6%) had a prior correct diagnosis and 31/102 (30.4%) had a misdiagnosis defined by post-BD FEV1/FVC ≥0.70. Underdiagnosis was associated with higher body mass index (≥30 kg/m2), milder airway obstruction (GOLD I-II), black skin color, absence of dyspnea, wheezing, no history of exacerbations or hospitalizations in the past-year. Those not visiting a doctor in the last year or only visiting a GP had more risk of underdiagnosis. COPD underdiagnosis (65.8%) and misdiagnosis (26.4%) were less prevalent in those with previous spirometry.COPD underdiagnosis is a major problem in primary care. Availability of spirometry should be a priority in this setting.http://europepmc.org/articles/PMC4830516?pdf=render
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Alejandro Casas Herrera Maria Montes de Oca Maria Victorina López Varela Carlos Aguirre Eduardo Schiavi José R Jardim PUMA Team
spellingShingle	Alejandro Casas Herrera Maria Montes de Oca Maria Victorina López Varela Carlos Aguirre Eduardo Schiavi José R Jardim PUMA Team COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study. PLoS ONE
author_facet	Alejandro Casas Herrera Maria Montes de Oca Maria Victorina López Varela Carlos Aguirre Eduardo Schiavi José R Jardim PUMA Team
author_sort	Alejandro Casas Herrera
title	COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.
title_short	COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.
title_full	COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.
title_fullStr	COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.
title_full_unstemmed	COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.
title_sort	copd underdiagnosis and misdiagnosis in a high-risk primary care population in four latin american countries. a key to enhance disease diagnosis: the puma study.
publisher	Public Library of Science (PLoS)
series	PLoS ONE
issn	1932-6203
publishDate	2016-01-01
description	Acknowledgement of COPD underdiagnosis and misdiagnosis in primary care can contribute to improved disease diagnosis. PUMA is an international primary care study in Argentina, Colombia, Venezuela and Uruguay.To assess COPD underdiagnosis and misdiagnosis in primary care and identify factors associated with COPD underdiagnosis in this setting.COPD was defined as post-bronchodilator (post-BD) forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) <0.70 and the lower limit of normal (LLN). Prior diagnosis was self-reported physician diagnosis of emphysema, chronic bronchitis, or COPD. Those patients with spirometric COPD were considered to have correct prior diagnosis, while those without spirometric criteria had misdiagnosis. Individuals with spirometric criteria without previous diagnosis were considered as underdiagnosed.1,743 patients were interviewed, 1,540 completed spirometry, 309 (post-BD FEV1/FVC <0.70) and 226 (LLN) had COPD. Underdiagnosis using post-BD FEV1/FVC <0.70 was 77% and 73% by LLN. Overall, 102 patients had a prior COPD diagnosis, 71/102 patients (69.6%) had a prior correct diagnosis and 31/102 (30.4%) had a misdiagnosis defined by post-BD FEV1/FVC ≥0.70. Underdiagnosis was associated with higher body mass index (≥30 kg/m2), milder airway obstruction (GOLD I-II), black skin color, absence of dyspnea, wheezing, no history of exacerbations or hospitalizations in the past-year. Those not visiting a doctor in the last year or only visiting a GP had more risk of underdiagnosis. COPD underdiagnosis (65.8%) and misdiagnosis (26.4%) were less prevalent in those with previous spirometry.COPD underdiagnosis is a major problem in primary care. Availability of spirometry should be a priority in this setting.
url	http://europepmc.org/articles/PMC4830516?pdf=render
work_keys_str_mv	AT alejandrocasasherrera copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy AT mariamontesdeoca copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy AT mariavictorinalopezvarela copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy AT carlosaguirre copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy AT eduardoschiavi copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy AT joserjardim copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy AT pumateam copdunderdiagnosisandmisdiagnosisinahighriskprimarycarepopulationinfourlatinamericancountriesakeytoenhancediseasediagnosisthepumastudy
_version_	1725417129697607680

COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study.

Similar Items