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A new screening tool for chronic obstructive pulmonary disease (COPD) delivered mixed results in a recent research study.

COPD impacts approximately 15 million people in the US each year. Although it is the fourth leading cause of death in the US, many people with the disease go undiagnosed. Because the disease is not on the radar for many primary care physicians, patients go untreated and the condition progresses.

COPD is a term that captures two primary disorders, emphysema and chronic bronchitis.  COPD is more likely to afflict people who smoke, or used to smoke.  That said, according to the National Heart, Lung, and Blood Institute, approximately 30 percent of those who suffer COPD never smoked.

At present, there is no cure for COPD and it is degenerative over time.  Despite that, with early intervention, lifestyle changes and treatment can improve quality of life and slow the development of the disease.  Given the seriousness of the condition, it is troubling that a reported 50 to 90 percent of patients with COPD go undiagnosed. Those with mild COPD may live into old age, while others may die prematurely of respiratory failure or pneumonia.

The development of a successful screening tool for healthcare providers may reduce the number of undiagnosed COPD patients.  A recent study in JAMA Network evaluated the CAPTURE (COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk) protocol.  Among other processes, the tool has five survey questions that include:

  1. Exposure to home or workplaces with polluted air, smoke, dust, or second-hand spoke
  2. Changes in patient breathing due to seasons, weather, or air quality
  3. Difficulty performing strenuous tasks due to shortness or difficulty breathing
  4. Rate at which the patient tires on exertion
  5. Frequency of experience of illness like bronchitis, colds, or pneumonia

Using primary care data from several research networks, researchers evaluated 4,325 patients between the ages of 40 and 80. Of these, 63 percent were women, reflecting the slightly higher prevalence of COPD in the female population.

Surprisingly, results of the research show the CAPTURE did not prove a reliable tool in identifying significant, undiagnosed COPD in patients of primary care physicians.  While it was able to identify some cases, researchers noted, “Further research is needed to optimize performance of the screening tool and to understand whether its use affects clinical outcomes.”

In the meantime, CAPTURE may help identify some cases of undiagnosed COPD, but cannot be universally relied upon for screening—leaving some patients unaware and vulnerable to the impacts of undiagnosed COPD.

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