RationaleStudies assessing dyspnoea and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD) have focused on patients in clinical settings, not the general population.ObjectivesCompare the prevalence and severity of dyspnoea and impaired HRQoL in individuals with and without COPD from the general population, focusing on mild-moderate COPD.MethodsAnalysis of the 3-year Canadian Cohort Obstructive Lung Disease (CanCOLD) study included four subgroups: mild-COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] 1); moderate-COPD (GOLD 2); non-COPD smokers; and non-COPD never-smokers. The primary outcome was dyspnoea (Medical Research Council [MRC] scale), and the secondary outcome was HRQoL (COPD Assessment Test [CAT] score; Saint George's Respiratory Questionnaire [SGRQ] score). Subgroups were analysed by sex, physician-diagnosed COPD status, and exacerbations.Results1443 participants (mild-COPD [n=397]; moderate-COPD [n=262]; smokers [n=449], and never-smokers [n=335]) were studied. People with mild-COPD were more likely to report more severe dyspnoea (MRC 2 versus 1 [MRC2 versus 1]) than those without COPD (OR [95%CI]: 1.42 [1.05,1.91]), and non-COPD never-smokers (OR [95%CI]: 1.64 [1.07,2.52]). Among people with mild-COPD, more severe dyspnoea was reported in women versus men (MRC2 versus 1; OR [95%CI]: 3.70 [2.23,6.14]); people with, versus without, physician-diagnosed COPD (MRC2 versus 1; OR [95%CI]: 3.27 [1.71,6.23]), and people with, versus without, recent exacerbations (MRC2 versus 1; ≥2 versus 0 exacerbations: OR [95%CI]: 3.62 [1.02,12.86]; MRC≥3 versus 1 [MRC≥3 versuss 1]; 1 versus 0 exacerbation: OR [95%CI]: 9.24 [2.01,42.42]). Similar between-group differences were obtained for CAT and SGRQ scores.ConclusionsCareful assessment of dyspnoea and HRQoL could help identify individuals for earlier diagnosis and treatment.
Accuracy of diagnosis of COPD and factors associated with misdiagnosis in primary care setting. E-DIAL (Early DIAgnosis of obstructive lung disease) study group
