Screening, Case-Finding, and Outcomes for Adults With Unrecognized COPD

Post date: Apr 6, 2016 10:47:51 AM

(…) The USPSTF Recommendation Statement also “encourages clinicians… to pursue active case finding for COPD in patients with risk factors, such as exposure to cigarette smoke…

(…) The distinction between persons who are truly asymptomatic and those who have symptomsthey have not reported—perhaps because they have not been asked—is a challenging concept in clinical care and research.

(…) The group that conducted the systematic review for USPSTF explicitly excluded analyses of studies that identified

previously undiagnosed patients with severe airflow obstruction given their relative rarity in population-based spirometric

screening studies (<5%)

(…)The USPSTF has done an admirable job in reviewing and interpreting available evidence, and the recommendation

against screening of truly asymptomatic patients for COPD is well reasoned, as such screening has not been shown to result in a clear net benefit.More research is needed, however, with respect to the “active case-finding for COPD,” among patients with risk factors, that is encouraged by the USPSTF report.

The effect of COPD case-finding approaches on health outcomes and health care expenditure has yet to be demonstrated. Additional investigation is required to develop innovative formats to identify persons with undiagnosed yet more severe COPD, or risk of developing severe airflow obstruction, that may be amenable to available treatments. Prospective examination of the benefit of such case-finding approaches on health care delivery and clinical outcomes is vital.

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