Controversies and Limitations in the Diagnosis of Chronic Obstructive Pulmonary Disease
2019
Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. While the cut-off
point to define airflow obstruction has been controversial, it is widely accepted that the spirometry test is vital, as well as
performing it after using a bronchodilator. The 6-second spirometry and the forced expiratory volume in 1 second/forced expiratory volume in 6 seconds (FEV1/FEV6) have demonstrated validity for defining obstruction, and it would be advisable to
incorporate them in the definitions of obstruction. Another relevant issue is that spirometry with borderline obstruction can
vary over time, changing to above or below the cut-off point. Thus, surveillance should be considered over time, repeating the
spirometry to have a greater certainty in the diagnosis. The objective of this article was to conduct an in-depth review of the
controversies in the diagnosis of COPD. During the past years, COPD definition has been updated in different times; however,
it is now considered more as a complex syndrome with systemic participation, requiring a multidimensional assessment, and
not only a spirometry. (REV INVEST CLIN. 2019;71:28-35)
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