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More than a quarter of COPD diagnoses could be wrong if they are made without using reversibility testing.

Norwegian research casts doubts on attempts to have one of the most controversial clinical indicators in the quality framework removed from the next draft.

NICE guidance published last year said reversibility testing might be 'unhelpful or misleading', and the GPC has hinted it would like to see spirometry dropped from the framework altogether.

But the new study, published online in Thorax this week, found reversibility testing could have a 'substantial' effect on diagnoses.

Researchers found the prevalence of COPD defined by GOLD guidelines in a sample of 2,235 adults was 9.5 per cent. But after carrying out reversibility testing with 0.3mg salbutamol, prevalence fell to 7 per cent.

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