Spirometry's Role in Early Detection and Diagnosis of COPD

Spirometry’s Role in Early Detection and Diagnosis of COPD

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties. These conditions include emphysema and chronic bronchitis. It's a common condition that affects middle-aged or older adults who smoke at large. The breathing issues it causes generally worsen over time and can limit normal, daily life activities.

The symptoms of COPD include getting increasingly breathless, having a persistent and chesty cough with phlegm, frequent chest infections, and persistent wheezing. COPD also may cause weight loss, tiredness, edema, and chest pains and coughing blood less commonly; but these additional symptoms generally only happen when the disease becomes advanced.

Early detection of COPD: Diagnosis processes

An issue with COPD is the fact that it remains very underdiagnosed in primary care because the presence of symptoms is not a reliable indicator for diagnosis. This causes the diagnosis to be frequently delayed until more severe obstructions in the airways become present and pressing. 

Spirometry is very under-utilized in the diagnosis of COPD, even though it is accepted as the diagnostic test to assess airflow obstructions and determine the severity of the disease

Early diagnosis creates more opportunities to prevent the worsening of the disease (by the patient quitting smoking, for example) and also can ensure that comorbidities are prevented

Spirometry and COPD 

Spirometry can detect COPD in the early stages, but the benefits are not limited only to detection. It can help track the progression of the disease and help narrow down the treatments that are most effective

Once the stage of COPD, meaning the classification of airflow limitation severity caused by the disease is determined, the healthcare team has the ability to set a treatment course accordingly.

According to Global Initiative for Chronic Obstructive Lung Disease, in patients with FEV1/FVC ratios less than 0.7, staging is as follows:

  • GOLD 1: Mild COPD, FEV1 percentage is less than 80% of the predicted percentage.
  • GOLD 2: Moderate COPD, FEV1 percentage is between 50% and 80% of the predicted percentage.
  • GOLD 3: Severe COPD, FEV1 percentage is between 30% and 50% of the predicted percentage.
  • GOLD 4: Very severe COPD, FEV1 percentage is less than 30% of the predicted percentage. 
The state of the disease guides the healthcare team of the patient in determining a course for treatment. Constant monitoring via home spirometry is also vital to ensure there are no unforeseen changes in the disease and any potential future obstructions can be better managed this way.

Sources 

  1. COPD: Symptoms and Causes”, Mayo Clinic, 2020.
  2. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease”, Global Initiative for Chronic Obstructive Lung, Gold Report, 2021.
  3. "Diagnosis and early detection of COPD using spirometry", Journal of Thoracic Disease, 2014.
  4. "Spirometry in Chronic Obstructive Pulmonary Disease. From Rule of Thumb to Science", American Journal of Respiratory and Critical Care Medicine, 2016. 

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