New COPD Diagnosis Criteria Broaden Scope, May Improve Outcomes for Millions
BOSTON, MA – A groundbreaking study published in JAMA is poised to redefine how Chronic Obstructive Pulmonary Disease (COPD) is diagnosed, possibly extending diagnosis to individuals previously overlooked despite experiencing important respiratory illness. Researchers, led by dr.Bhatt and colleagues,have developed a new,multidimensional diagnostic schema that moves beyond relying solely on traditional lung function tests.
The study, involving 9,416 participants across a multicenter cohort, revealed that individuals newly diagnosed with COPD using this expanded criteria experienced higher rates of all-cause and respiratory-related mortality, more frequent exacerbations, and a faster decline in lung function compared to those not classified as having COPD.Crucially, the new schema incorporates individuals with substantial respiratory problems who might not exhibit typical airflow obstruction, while also excluding those with airflow limitations but no accompanying symptoms or lung damage.
For years,clinicians have acknowledged the limitations of spirometry – a common lung function test – in fully capturing the complexity of COPD,a disease affecting an estimated 392 million people worldwide and 16 million in the United States. The new approach acknowledges that COPD presents in diverse ways.”This new diagnostic schema will likely change the way we diagnose COPD and enable its diagnosis, even in the absence of overt airflow obstruction on spirometry,” explained Dr. Bhatt. While treatment outcomes with this new diagnostic approach remain to be seen, the schema formalizes practices already underway, utilizing imaging and symptom assessment alongside traditional testing.
An accompanying editorial in JAMA, authored by Dr. Francesca Polverino of Baylor College of Medicine, hailed the study as a “milestone” in COPD diagnosis. Dr. Polverino emphasized the study’s pivotal assertion: airflow obstruction is no longer a mandatory requirement for a COPD diagnosis.
The revised system still considers airflow obstruction a primary criterion, but considerably expands diagnostic considerations through “minor criteria” encompassing both imaging findings and patient-reported symptoms. This inclusive approach aims to better reflect the clinical diversity of COPD.
The study was a collaborative effort involving 52 authors from 24 institutions across the United States and Canada. Researchers from the University of Alabama at Birmingham (UAB), including Dr. Bhatt from the Division of Pulmonary, Allergy and Critical Care Medicine, played a key role in the research.
Further details of the study, titled “A new multidimensional diagnostic approach for chronic obstructive pulmonary disease,” can be found at https://jamanetwork.com/journals/jama/fullarticle/2834253.
