Physician Assessment of COPD Does Not Match Spirometry Results


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Am Fam Physician. 2015 Oct 1;92(7):635a-640.

Clinical Question

How accurate are physician assessments of the severity of chronic obstructive pulmonary disease (COPD)?

Bottom Line

Using immediate, in-office spirometry results as the reference standard, seasoned physicians accurately identified COPD severity in approximately one in three patients, underestimating severity in 41% of patients and overestimating severity in 29% of patients. This mismatch seems to be important because the physicians participating in this study changed their treatment plans for 37% of patients after reviewing the spirometry results. A second issue in this study: Although most of the physicians in the study had a spirometer in their office, they (or their staff) were unable to get usable

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Medical Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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