Spirometry and questionnaire use for early diagnosis of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) carries a significant health care burden that is currently underrecognized, underdiagnosed, and undertreated. The identification of those with symptomatic COPD at all stages of severity requires novel approaches to identify this missing population. In addition, many patients with COPD are misdiagnosed as having asthma and are incorrectly managed.
Tools to identify this symptomatic population include case-finding approaches using questions or questionnaires at point of contact or in an organized approach, followed by case-finding spirometry and then diagnostic spirometry or straight-to-diagnostic spirometry. It is also essential that we make approaching health care professionals with symptoms of COPD a respectable and worthwhile action for patients who often assume they will not receive help.
Case-finding approaches are being increasingly adopted across the world and appear to be both feasible and effective in reducing underdiagnosis and misdiagnosis. There is also some evidence that such approaches may reduce smoking behavior and, from the Finnish National Prevention and Treatment Programme for Chronic Bronchitis, that they may improve outcomes in COPD.