Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Gogou, Evdoxia; Kotsiou, Ourania S.; Siachpazidou, Dimitra; Pinaka, Maria; Varsamas, Charalampos; Bardaka, Fotini; Gerogianni, Irini; Hatzoglou, Chrissi; Gourgoulianis, Konstantinos

doi:10.1038/s41533-021-00226-y

Cited by 6 publications

(5 citation statements)

References 48 publications

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“…COPD is substantially underdiagnosed, with only 10–15% of all cases identified globally [ 20 ]. In a recent study in the Greek rural population aged 40–65, it was verified that the respiratory symptoms of smokers were underestimated and thus not diagnosed as COPD cases, suggesting that the actual COPD prevalence in Greece may be even higher [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The spirometry procedure was conducted as previously outlined in studies in the community by our research team [ 11 ]. More specifically, the spirometry test was performed with a dry spirometer (Spirolab FCC ID: TUK-MIR045) according to the American Thoracic Society’s recommendations [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…A bronchodilator reversibility test with 400 µg of salbutamol was performed in all patients with baseline prebronchodilator obstructive spirometry. A positive response to bronchodilators was defined as an increase in the FEV1 or FVC of 200 mL and 12% from the prebronchodilator value (baseline value) [ 11 , 14 , 16 ]. All participants with a positive bronchodilator response were excluded from the analyses.…”

Section: Methodsmentioning

confidence: 99%

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The Alonissos Study: Cross-Sectional Study of the Community Respiratory Health Status in a Greek Healthcare Access Underprivileged Island

et al. 2022

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In this study, we investigated the self-reported (questionnaire-based) prevalence of Obstructive Sleep Apnoea Syndrome (OSAS) and the prevalence of Chronic Obstructive Pulmonary Diseases (COPD) in the context of demographics and adherence to the Mediterranean diet in the general population of Alonissos, a non-profit line island in Greece (i.e., with scarce boat transportation to the mainland). In this cross-sectional study, 236 inhabitants of Alonissos participated (circa 10% of the island’s population), and 115 males and 121 females were evaluated with appropriate questionnaires for OSAS, COPD, and adherence to the Mediterranean diet and subsequently underwent spirometry testing to establish COPD diagnosis. The self-reported prevalence of OSAS and COPD was 9.44% and 18.8%, respectively. However, only 8.99% of the participants were diagnosed with COPD based on their spirometry testing. Adherence to the Mediterranean Diet was moderate. The high prevalence of COPD and OSAS in this underprivileged island in terms of healthcare access highlights the need for improvements in health promotion and primary healthcare provision in non-profit line Greek islands.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Alonissos Study: Cross-Sectional Study of the Community Respiratory Health Status in a Greek Healthcare Access Underprivileged Island

et al. 2022

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“…Not surprisingly, 14.5% of the newly diagnosed COPD population was reported as asymptomatic in primary care clinics. [ 81 ] Also, there is a high prevalence of COPD among smokers with no symptoms. [ 82 ] Subjectively reported or observed clinical symptoms were not considered; instead, the analysis is based only on objectively measured parameters (i.e., physiological signals).…”

Section: Methodsmentioning

confidence: 99%

Fractional Dynamics Foster Deep Learning of COPD Stage Prediction

et al. 2023

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Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Current COPD diagnosis (i.e., spirometry) could be unreliable because the test depends on an adequate effort from the tester and testee. Moreover, the early diagnosis of COPD is challenging. The authors address COPD detection by constructing two novel physiological signals datasets (4432 records from 54 patients in the WestRo COPD dataset and 13824 medical records from 534 patients in the WestRo Porti COPD dataset). The authors demonstrate their complex coupled fractal dynamical characteristics and perform a fractional‐order dynamics deep learning analysis to diagnose COPD. The authors found that the fractional‐order dynamical modeling can extract distinguishing signatures from the physiological signals across patients with all COPD stages—from stage 0 (healthy) to stage 4 (very severe). They use the fractional signatures to develop and train a deep neural network that predicts COPD stages based on the input features (such as thorax breathing effort, respiratory rate, or oxygen saturation). The authors show that the fractional dynamic deep learning model (FDDLM) achieves a COPD prediction accuracy of 98.66% and can serve as a robust alternative to spirometry. The FDDLM also has high accuracy when validated on a dataset with different physiological signals.

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“…COPD is a multifactorial disease, with tobacco smoke being the best-known and most important risk factor for irreversible airflow obstruction [8,9]. However, nonsmokers can also develop COPD.…”

Section: Introductionmentioning

confidence: 99%

Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

AL Wachami,

Guennouni,

Iderdar

et al. 2024

BMC Public Health

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Background Chronic obstructive pulmonary disease (COPD) is a major public health problem. The present study aims to provide a global and regional estimate of the prevalence of COPD based on spirometry according to the two most widely used diagnostic criteria of COPD: fixed ratio (FR) and lower limit of normal (LLN). Methods We conducted a systematic review of the literature according to PRISMA guidelines. MEDLINE, Web of Sciences, and Scopus databases were searched to identify studies on the spirometry-based prevalence of COPD in individuals aged 40 years and older. The meta-analysis was performed using MedCalc 19 software. Results In total, 42 of the 3393 studies reviewed were eligible for inclusion. The overall prevalence of COPD in people aged 40 years and older was 12.64% (95% CI 10.75%-14.65%) and 7.38% (95% CI 5.47% − 9.55%) based on FR and LLN criteria, respectively. By gender, men had a higher prevalence of COPD compared to women (15.47%; 95% CI 12.22%-19.02% for men versus 8.79%; 95% CI 6.94%-10.82% for women). Using the LLN criteria, the prevalence of COPD in both sexes was almost identical (8.67%; 95% CI 8.44%- 8.90% for men and 8.00%; 95% CI 6.42% − 9.73% for women). We reported a high prevalence of COPD among smokers and the elderly by both definitions of airway obstruction. Regional prevalence estimates using the FR definition indicate that the highest COPD prevalence was recorded in the Americas and the lowest was recorded in the Eastern Mediterranean region. Using the LLN definition, the highest prevalence was recorded in the Southeast Asian region and the lowest prevalence was recorded in the American region. The most common COPD stage was stage II, with a prevalence of 50.46%. The results indicate a huge lack of prevalence data in the African and Eastern Mediterranean region. The results were given using a random-effect model due to the high heterogeneity between studies. Conclusion Results show that the prevalence of COPD differs according to the diagnostic criteria used. In addition, management and prevention strategies targeting risk factors for COPD are certainly needed to reduce the global burden of this chronic respiratory disease.

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Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Cited by 6 publications

References 48 publications

The Alonissos Study: Cross-Sectional Study of the Community Respiratory Health Status in a Greek Healthcare Access Underprivileged Island

The Alonissos Study: Cross-Sectional Study of the Community Respiratory Health Status in a Greek Healthcare Access Underprivileged Island

Fractional Dynamics Foster Deep Learning of COPD Stage Prediction

Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

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