Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease?
Katja Oshaug, Peder A Halvorsen, Hasse Melbye General Practice Research Unit, University of Tromsø, Tromsø, Norway Background: Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2013-07-01
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| Series: | International Journal of COPD |
| Online Access: | http://www.dovepress.com/should-chest-examination-be-reinstated-in-the-early-diagnosis-of-chron-a13858 |
| _version_ | 1811341148941189120 |
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| author | Oshaug K Halvorsen PA Melbye H |
| author_facet | Oshaug K Halvorsen PA Melbye H |
| author_sort | Oshaug K |
| collection | DOAJ |
| description | Katja Oshaug, Peder A Halvorsen, Hasse Melbye General Practice Research Unit, University of Tromsø, Tromsø, Norway Background: Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD) in established guidelines. Aims: We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. Methods: In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Results: Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity <0.7. Hyperresonance to percussion was the strongest predictor of COPD, with a sensitivity of 20.8, a specificity of 97.8, and likelihood ratio of 9.5. In multivariate logistic regression, where pack-years, shortness of breath, and chest findings were among the explanatory variables, three physical chest findings were independent predictors of COPD. Hyperresonance to percussion yielded the highest odds ratio (OR = 6.7), followed by diminished breath sounds (OR = 5.0), and thirdly wheezes (OR = 2.3). These three chest signs also gave significant diagnostic information when added to shortness of breath and pack-years in receiver operating-characteristic curve analysis. Conclusion: We found that chest signs may add to respiratory symptoms and a history of smoking in the diagnosis of COPD, and we conclude that chest signs should be reinstated as cues to early diagnosis of COPD in patients 40 years or older. Keywords: diagnosis, COPD, physical chest examination, spirometry |
| first_indexed | 2024-04-13T18:52:29Z |
| format | Article |
| id | doaj.art-2c63623163b64f5489e4d2bd25f30c71 |
| institution | Directory Open Access Journal |
| issn | 1176-9106 1178-2005 |
| language | English |
| last_indexed | 2024-04-13T18:52:29Z |
| publishDate | 2013-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-2c63623163b64f5489e4d2bd25f30c712022-12-22T02:34:21ZengDove Medical PressInternational Journal of COPD1176-91061178-20052013-07-012013default369377Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease?Oshaug KHalvorsen PAMelbye HKatja Oshaug, Peder A Halvorsen, Hasse Melbye General Practice Research Unit, University of Tromsø, Tromsø, Norway Background: Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD) in established guidelines. Aims: We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. Methods: In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Results: Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity <0.7. Hyperresonance to percussion was the strongest predictor of COPD, with a sensitivity of 20.8, a specificity of 97.8, and likelihood ratio of 9.5. In multivariate logistic regression, where pack-years, shortness of breath, and chest findings were among the explanatory variables, three physical chest findings were independent predictors of COPD. Hyperresonance to percussion yielded the highest odds ratio (OR = 6.7), followed by diminished breath sounds (OR = 5.0), and thirdly wheezes (OR = 2.3). These three chest signs also gave significant diagnostic information when added to shortness of breath and pack-years in receiver operating-characteristic curve analysis. Conclusion: We found that chest signs may add to respiratory symptoms and a history of smoking in the diagnosis of COPD, and we conclude that chest signs should be reinstated as cues to early diagnosis of COPD in patients 40 years or older. Keywords: diagnosis, COPD, physical chest examination, spirometryhttp://www.dovepress.com/should-chest-examination-be-reinstated-in-the-early-diagnosis-of-chron-a13858 |
| spellingShingle | Oshaug K Halvorsen PA Melbye H Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease? International Journal of COPD |
| title | Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease? |
| title_full | Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease? |
| title_fullStr | Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease? |
| title_full_unstemmed | Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease? |
| title_short | Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease? |
| title_sort | should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease |
| url | http://www.dovepress.com/should-chest-examination-be-reinstated-in-the-early-diagnosis-of-chron-a13858 |
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