Chronic obstructive pulmonary disease study of choice: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 3: Line 3:
{{CMG}}; {{AE}}
{{CMG}}; {{AE}}
==Overview==
==Overview==
The diagnosis of COPD is confirmed by [[spirometry]], a test that measures the forced expiratory volume in one second (FEV<sub>1</sub>), which is the greatest volume of air that can be breathed out in the first second of a large breath. Spirometry also measures the forced vital capacity (FVC), which is the greatest volume of air that can be breathed out in a whole large breath. Normally, at least 70% of the FVC comes out in the first second (i.e. the [[FEV1/FVC|FEV<sub>1</sub>/FVC ratio]] is >70%). A ratio less than normal defines the patient as having COPD. Six minute walk tests act as an predictor of mortality in patients with moderate COPD (patients who desaturate have worse mortality compared with those who don't desaturate.)


==Diagnostic Study of Choice==
==Diagnostic Study of Choice==
Line 9: Line 12:


===Pulmonary Function Test / Spirometry===
===Pulmonary Function Test / Spirometry===
 
*Many patients labeled as having airway obstruction do not have obstruction when tested<ref name="pmid30711480">{{cite journal| author=Sator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, McBurnie MA et al.| title=Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis. | journal=Chest | year= 2019 | volume= 156 | issue= 2 | pages= 277-288 | pmid=30711480 | doi=10.1016/j.chest.2019.01.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30711480  }} </ref>.
*COPD is particularly characterized if a ratio of forced expiratory volume over 1 second ([https://www.wikidoc.org/index.php/FEV1 FEV<sub>1</sub>]) to [https://www.wikidoc.org/index.php/Forced_vital_capacity forced vital capacity] (FVC) being < 0.7 and the [https://www.wikidoc.org/index.php/FEV1 FEV<sub>1</sub>]  < 70% of the predicted value when compared with a matched control. <ref>[http://www.patient.co.uk/showdoc/40002357/ PatientPlus - Spirometry]</ref>, <ref name="pmid22319804">{{cite journal |author= |title= |journal=[[]] |volume= |issue= |pages= |year= |pmid=22319804 |doi= |url= |accessdate=2012-03-05}}</ref> (see [[Spirometry]]).
*COPD is particularly characterized if a ratio of forced expiratory volume over 1 second ([https://www.wikidoc.org/index.php/FEV1 FEV<sub>1</sub>]) to [https://www.wikidoc.org/index.php/Forced_vital_capacity forced vital capacity] (FVC) being < 0.7 and the [https://www.wikidoc.org/index.php/FEV1 FEV<sub>1</sub>]  < 70% of the predicted value when compared with a matched control. <ref>[http://www.patient.co.uk/showdoc/40002357/ PatientPlus - Spirometry]</ref>, <ref name="pmid22319804">{{cite journal |author= |title= |journal=[[]] |volume= |issue= |pages= |year= |pmid=22319804 |doi= |url= |accessdate=2012-03-05}}</ref> (see [[Spirometry]]).<ref name="pmid17507545">{{cite journal |author=Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J |title=Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary |journal=[[American Journal of Respiratory and Critical Care Medicine]] |volume=176 |issue=6 |pages=532–55 |year=2007 |month=September |pmid=17507545 |doi=10.1164/rccm.200703-456SO |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=17507545 |accessdate=2012-03-02}}</ref>


*Normally, at least 70% of the FVC comes out in the first second (i.e. the [https://www.wikidoc.org/index.php/FEV1/FVC FEV<sub>1</sub>/FVC ratio] is >70%). A ratio less than normal defines the patient as having COPD.
*Normally, at least 70% of the FVC comes out in the first second (i.e. the [https://www.wikidoc.org/index.php/FEV1/FVC FEV<sub>1</sub>/FVC ratio] is >70%). A ratio less than normal defines the patient as having COPD.

Revision as of 15:54, 12 January 2021

Chronic obstructive pulmonary disease Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chronic obstructive pulmonary disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography or Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Chronic obstructive pulmonary disease study of choice On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chronic obstructive pulmonary disease study of choice

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chronic obstructive pulmonary disease study of choice

CDC on Chronic obstructive pulmonary disease study of choice

Chronic obstructive pulmonary disease study of choice in the news

Blogs on Chronic obstructive pulmonary disease study of choice

Directions to Hospitals Treating Chronic obstructive pulmonary disease

Risk calculators and risk factors for Chronic obstructive pulmonary disease study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The diagnosis of COPD is confirmed by spirometry, a test that measures the forced expiratory volume in one second (FEV1), which is the greatest volume of air that can be breathed out in the first second of a large breath. Spirometry also measures the forced vital capacity (FVC), which is the greatest volume of air that can be breathed out in a whole large breath. Normally, at least 70% of the FVC comes out in the first second (i.e. the FEV1/FVC ratio is >70%). A ratio less than normal defines the patient as having COPD. Six minute walk tests act as an predictor of mortality in patients with moderate COPD (patients who desaturate have worse mortality compared with those who don't desaturate.)


Diagnostic Study of Choice

Study of choice

Pulmonary Function Test / Spirometry

  • Many patients labeled as having airway obstruction do not have obstruction when tested[1].
  • COPD is particularly characterized if a ratio of forced expiratory volume over 1 second (FEV1) to forced vital capacity (FVC) being < 0.7 and the FEV1 < 70% of the predicted value when compared with a matched control. [2], [3] (see Spirometry).[4]
  • Normally, at least 70% of the FVC comes out in the first second (i.e. the FEV1/FVC ratio is >70%). A ratio less than normal defines the patient as having COPD.
  • More specifically, the diagnosis of COPD is made when the FEV1/FVC ratio is <70%.
  • The GOLD criteria also require that values are after bronchodilator medication has been given to make the diagnosis,
  • The NICE criteria also require FEV1%.
  • According to the ERS criteria, it is FEV1% predicted that defines when a patient has COPD, that is, when FEV1% predicted is < 88% for men, or < 89% for women.
  • Spirometry can help to determine the severity of COPD.[4]
  • The FEV1 (measured after bronchodilator medication) is expressed as a percentage of a predicted "normal" value based on a person's age, gender, height and weight:
  • The severity of COPD also depends on the severity of dyspnea and exercise limitation. These and other factors can be combined with spirometry results to obtain a COPD severity score that takes multiple dimensions of the disease into account.[5]

References

  1. Sator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, McBurnie MA; et al. (2019). "Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis". Chest. 156 (2): 277–288. doi:10.1016/j.chest.2019.01.015. PMID 30711480.
  2. PatientPlus - Spirometry
  3. [[]]. PMID 22319804. Missing or empty |title= (help); |access-date= requires |url= (help)
  4. 4.0 4.1 Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J (2007). "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary". American Journal of Respiratory and Critical Care Medicine. 176 (6): 532–55. doi:10.1164/rccm.200703-456SO. PMID 17507545. Retrieved 2012-03-02. Unknown parameter |month= ignored (help)
  5. Celli BR, Cote CG, Marin JM; et al. (2004). "The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease". N. Engl. J. Med. 350 (10): 1005–12. doi:10.1056/NEJMoa021322. PMID 14999112. Unknown parameter |month= ignored (help)