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The diagnosis of COPD in primary care; gender differences and the role of spirometry

Roberts, N.J.; Patel, I.S.; Partridge, M.R.

Authors

I.S. Patel

M.R. Partridge



Abstract

Background
Females with exacerbations of Chronic Obstructive Pulmonary Disease now account for one half of all hospital admissions for that condition and rates have been increasing over the last few decades. Differences in presentations of disease between genders have been shown in several conditions and this study explores whether there are inter gender biases in probable diagnoses in those suspected to have COPD.
Methods
445 individuals with a provisional diagnosis by their General Practitioner of “suspected COPD” or “definite COPD” were referred to a community Respiratory Assessment unit (CRAU) for tests including spirometry. Gender, demographics, respiratory symptoms and respiratory medical history were recorded. The provisional diagnoses were compared with the final diagnosis made after spirometry and respiratory specialist nurse review and the provisional diagnosis was either confirmed as correct or refuted as unlikely.
Results
Significantly more men (87.5%) had their diagnosis of “definite COPD” confirmed compared to 73.9% of women (p = 0.021). When the GP suggested a provisional diagnosis of “suspected COPD” (n = 265) at referral, this was confirmed in 60.9% of men and only 43.2% of women (p = 0.004). There was a different symptom pattern between genders with women being more likely to report allergies, symptoms starting earlier in life, and being less likely than men to report breathlessness as the main symptom.
Conclusions: These results may suggest a difference between genders in some of the clinical features of COPD and a difference in likelihood of a GPs provisional diagnosis of COPD being correct. The study reiterates the absolute importance of spirometry in the diagnosis of COPD.

Journal Article Type Article
Acceptance Date Dec 17, 2015
Online Publication Date Dec 18, 2015
Publication Date 2016-02
Deposit Date Aug 30, 2022
Journal Respiratory Medicine
Print ISSN 0954-6111
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 111
Pages 60-63
DOI https://doi.org/10.1016/j.rmed.2015.12.008
Keywords COPD, Diagnosis, Spirometry
Public URL http://researchrepository.napier.ac.uk/Output/2899533