Can a normal peak expiratory flow exclude severe chronic obstructive pulmonary disease

摘要: Although chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide,1 it greatly underdiagnosed.2 International guidelines now recommend documenting i rreversible airflow obstruction, assessed via post-bronchodilator (post-BD) spirometry, as the primary diagnostic test for COPD, before an inhaler prescription considered.1 Despite increasing availability relatively low-cost, easy to use office spirometers,3,4 spirometry not often available in care setting economic factors may limit specialty referrals testing. This problem further exacerbated resource-poor countries which even least expensive spirometers be luxury many practitioners unaffordable patients. In this context, access simple, inexpensive, interpret screen patients identify those most likely benefit from highly desirable goal. Measurement peak expiratory flow (PEF) requires only short maximal expiration, demands required patient technician achieve reliable data are fewer than spirometry. previous studies have concluded that PEF adequate substitute diagnosis COPD,5,6 these did evaluate possible value screening tool reduce need adults with COPD risk factors. The used report Latin American Project Investigation Obstructive Lung Diseases (PLATINO) study7 ongoing Burden Disease (BOLD) study.8 These population-based prevalence shared common protocol been carried out date over 17 around world. We tested whether PEF, bronchodilator using diagnostic-quality spirometer trained technicians, identified spirometrically confirmed post-BD obstruction.