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COPD underdiagnosis and misdiagnosis in a high-risk primary care population in four Latin American countries. A key to enhance disease diagnosis : The PUMA study

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dc.creatorCasas Herrera, Alejandro
dc.creatorMontes de Oca, Maria
dc.creatorLópez Varela, Maria Victorina
dc.creatorAguirre, Carlos
dc.creatorSchiav, Eduardo
dc.creatorJardim, José R.
dc.creatorPUMA Team
dc.creator.googleCasas Herrera, Alejandrospa
dc.creator.googleMontes de Oca, Mariaspa
dc.creator.googleLópez Varela, Maria Victorinaspa
dc.creator.googleAguirre, Carlosspa
dc.creator.googleSchiav, Eduardospa
dc.creator.googleJardim, José R.spa
dc.creator.googlePUMA Teamspa
dc.date.accessioned2019-01-28T17:54:20Z
dc.date.available2019-01-28T17:54:20Z
dc.date.created2016-04-13
dc.date.issued2016
dc.description.abstractBackground Acknowledgement of COPD underdiagnosis and misdiagnosis in primary care can contribute to improved disease diagnosis. PUMA is an international primary care study in Argentina, Colombia, Venezuela and Uruguay. Objectives To assess COPD underdiagnosis and misdiagnosis in primary care and identify factors associated with COPD underdiagnosis in this setting. Methods COPD was defined as post-bronchodilator (post-BD) forced expiratory volume in 1 second/ forced vital capacity (FEV1/FVC) <0.70 and the lower limit of normal (LLN). Prior diagnosis was self-reported physician diagnosis of emphysema, chronic bronchitis, or COPD. Those patients with spirometric COPD were considered to have correct prior diagnosis, while those without spirometric criteria had misdiagnosis. Individuals with spirometric criteria without previous diagnosis were considered as underdiagnosed. Results 1,743 patients were interviewed, 1,540 completed spirometry, 309 (post-BD FEV1/FVC <0.70) and 226 (LLN) had COPD. Underdiagnosis using post-BD FEV1/FVC <0.70 was 77% and 73% by LLN. Overall, 102 patients had a prior COPD diagnosis, 71/102 patients 69.6%) had a prior correct diagnosis and 31/102 (30.4%) had a misdiagnosis defined by post-BD FEV1/FVC ≥0.70. Underdiagnosis was associated with higher body mass index (≥30 kg/m2), milder airway obstruction (GOLD I-II), black skin color, absence of dyspnea, wheezing, no history of exacerbations or hospitalizations in the past-year. Those not visiting a doctor in the last year or only visiting a GP had more risk of underdiagnosis. COPD underdiagnosis (65.8%) and misdiagnosis (26.4%) were less prevalent in those with previous spirometry. Conclusions COPD underdiagnosis is a major problem in primary care. Availability of spirometry should be a priority in this setting. © 2016 Casas Herrera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0152266
dc.identifier.issn1932-6203
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/18942
dc.language.isoengspa
dc.relation.citationEndPage13
dc.relation.citationIssueNo. 4
dc.relation.citationStartPage1
dc.relation.citationTitlePLoS ONE
dc.relation.citationVolumeVol. 11
dc.relation.ispartofPLoS ONE, ISSN: 1932-6203, Vol. 11/No. 4 (2016); pp.1-13spa
dc.relation.urihttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0152266&type=printablespa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.rights.cchttps://creativecommons.org/licenses/by/4.0/spa
dc.source.bibliographicCitationLamprecht, B., Soriano, J.B., Studnicka, M., Kaiser, B., Vanfleteren, L.E., Gnatiuc, L., Determinants of Underdiagnosis of COPD in national and international surveys (2015) Chest, 148, pp. 971-985. , PMID: 25950276spa
dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subject.ddcEnfermedadesspa
dc.subject.keywordAirway Obstructioneng
dc.subject.keywordChronic Obstructiveeng
dc.subject.keywordChronic Obstructiveeng
dc.subject.keywordBlack Personeng
dc.subject.keywordBody Masseng
dc.subject.keywordChronic Bronchitiseng
dc.subject.keywordChronic Obstructive Lung Diseaseeng
dc.subject.keywordDiagnostic Accuracyeng
dc.subject.keywordDiagnostic Erroreng
dc.subject.keywordDisease Associationeng
dc.subject.keywordDisease Exacerbationeng
dc.subject.keywordDyspneaeng
dc.subject.keywordEmphysemaeng
dc.subject.keywordForced Expiratory Volumeeng
dc.subject.keywordForced Vital Capacityeng
dc.subject.keywordGeneral Practitionereng
dc.subject.keywordHigh Risk Populationeng
dc.subject.keywordHospitalizationeng
dc.subject.keywordLower Limit Of Normaleng
dc.subject.keywordMajor Clinical Studyeng
dc.subject.keywordPhysicianeng
dc.subject.keywordPrimary Medical Careeng
dc.subject.keywordRespiratory Tract Parameterseng
dc.subject.keywordSelf Reporteng
dc.subject.keywordSouth And Central Americaeng
dc.subject.keywordSpirometryeng
dc.subject.keywordWheezingeng
dc.subject.keywordClinical Trialeng
dc.subject.keywordMulticenter Studyeng
dc.subject.keywordPathophysiologyeng
dc.subject.keywordPrevalenceeng
dc.subject.keywordPrimary Health Careeng
dc.subject.keywordPulmonary Diseaseeng
dc.subject.keywordSouth And Central Americaeng
dc.subject.keywordDiagnostic Errorseng
dc.subject.keywordLatin Americaeng
dc.subject.keywordPrevalenceeng
dc.subject.keywordPrimary Health Careeng
dc.subject.keywordPulmonary Diseaseeng
dc.subject.lembEnfermedad Pulmonar Obstructiva Crónicaspa
dc.subject.lembObstrucción de las vías aéreasspa
dc.subject.lembEspirometríaspa
dc.titleCOPD underdiagnosis and misdiagnosis in a high-risk primary care population in four Latin American countries. A key to enhance disease diagnosis : The PUMA studyspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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