Case Definitions for Chronic Obstructive Pulmonary Disease

Details

• Personal Author:
  Buist AS ; Enright, Paul L. ; Glindmeyer HW ; Hnizdo, Eva ; Petsonk, Edward L.
• Description:
  The objective of this study was to evaluate the definitions for classification of chronic obstructive pulmonary disease (COPD) recommended by the American Thoracic Society (ATS) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Using data from the U.S. population-based third National Health and Nutrition Examination Survey (NHANES III), we compared the number of individuals in the U.S. population who met definitions of airflow obstruction based on the fixed ratio of FEV1/FVC < 0.70 criterion and on the ATS lower 95% confidence limit (lower limits of normal LLN) criterion. Further, we evaluated the definitions in the context of physician-diagnosed obstructive airways diseases and respiratory symptoms. In comparison to the FEV1/FVC < LLN and FEV1 < 100% predicted definition, the fixed ratio-based definition for mild COPD underestimates airflow obstruction by 29% in 20-49-year-olds and overestimates it by 58% in 50-80-year-olds. In comparison to the FEV1/FVC < LLN and FEV1 < LLN definition, the fixed ratio-based definition for moderate COPD underestimates airflow obstruction by 31% in 20-49-year-olds and overestimates it by 37% in 50-80 year olds. Based on our estimation, approximately 0.9 million (26%) of symptomatic individuals out of the 3.6 million U.S. adults aged 20-49 years who have airflow obstruction (FEV1/FVC < LLN and FEV1 < LLN definition) may have undiagnosed respiratory disease. In conclusion, using the FEV1/FVC < 0.70 criterion will substantially under-diagnose airway obstruction in younger individuals and substantially over-diagnose COPD in older individuals. [Description provided by NIOSH]
• Subjects:
  Epidemiology Lung Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Airflow Obstruction Author Keywords: COPD Definition Chronic Obstructive Pulmonary Disease COPD Diagnosis Of COPD Lung Disease Lung Disorders Pulmonary System Disorders Respiratory Irritants Respiratory System Disorders Surveillance

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• ISSN:
  1541-2555
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Arizona ; Louisiana ; Oregon ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 6 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  95-100
• Volume:
  3
• Issue:
  2
• NIOSHTIC Number:
  nn:20030636
• Citation:
  COPD 2006 Jun; 3(2):95-100
• Contact Point Address:
  Eva Hnizdo, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd, Morgantown, WV 26505 USA
• Email:
  ehnizdo@cdc.gov
• Federal Fiscal Year:
  2006
• NORA Priority Area:
  Disease and Injury: Asthma and Chronic Obstructive Pulmonary Disease
• Peer Reviewed:
  True
• Source Full Name:
  COPD: Journal of Chronic Obstructive Pulmonary Disease
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3889b7884dc85dfb59a8e60256129090fd64a8f330566e1f4c1b18f075911eef30cd7ea79a8cbfb5ecba64f663017cac196737a83296433a52667840175b0fcb
• Download URL:
  https://stacks.cdc.gov/view/cdc/191179/cdc_191179_DS1.pdf
• File Type:
  [PDF - 1.63 MB ]