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Independents' Day

COPD postal screen

Screening patients by post for key indicators of COPD can improve its diagnosis, an international team concludes.

Researchers evaluated a 54-part questionnaire sent out to patients' homes. They said using a selection of the questions ­ which could also be completed in waiting rooms ­ could prevent COPD being missed or wrongly diagnosed.

Professor David Price, a GP in Norfolk and one of the study researchers, said: 'We have underdiagnosis and misdiagnosis.

'There are two issues ­ 15 per cent of smokers over 40 have COPD that's not diagnosed and a quarter of people over 40 with asthma diagnoses actually have COPD.

'We've identified this as a major priority for the future.'

Professor Price, professor of primary care respiratory medicine at the University of Aberdeen, said GPs currently had to screen large numbers of patient to confirm one person with COPD ­ but the questionnaire would narrow this down to one in two.

Eight questions identified COPD in smokers, including those on wheeze frequency and presence of allergies, and nine helped distinguish COPD from asthma (see box, left).

Dr Tony Crockett, a GP in Shrivenham, Wiltshire, and a hospital practitioner in asthma and COPD, told Pulse: 'I think they [the questions] will be very useful ­ for a lot of practices those are the key issues.'

Researchers tested the questionnaire in 818 current or former smokers and 597 patients with a prior diagnosis of obstructive lung disease at primary care practices in Aberdeen, UK, and Denver, US.

The evaluations were published online as separate studies in Respiration.

COPD diagnosis

COPD in smokers

  • Age
  • BMI
  • Smoking intensity
  • Weather-affected cough
  • Phlegm without a cold
  • Phlegm first thing in morning
  • Wheeze frequency
  • Allergies

Distinguishing COPD from asthma

  • Age
  • Smoking intensity
  • More cough in last three years
  • Kept off work, indoors, at home or in bed by breathing problems
  • Admitted to hospital with breathing problems
  • Short of breath more often in last three years
  • Phlegm per day
  • Colds that go to chest
  • Taking treatment for breathing

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